{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T11:08:31Z","timestamp":1779966511116,"version":"3.53.1"},"reference-count":22,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T00:00:00Z","timestamp":1778457600000},"content-version":"vor","delay-in-days":10,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["JGH Open"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      Idiopathic pulmonary fibrosis (IPF) is a progressive lung disease with poor prognosis. Patients with IPF are frequently exposed to risk factors for\n                      <jats:styled-content style=\"fixed-case\">\n                        <jats:italic>Clostridium difficile<\/jats:italic>\n                      <\/jats:styled-content>\n                      infection (CDI), such as advanced age, antibiotic use, and gastric acid suppression. However, the outcomes of CDI in hospitalized IPF patients remain unclear.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective cohort study using the National Inpatient Sample (2016\u20132020) to compare outcomes among hospitalized CDI adults with or without IPF as a pre\u2010existing comorbidity. Hospitalizations were identified using ICD\u201010 codes. Propensity score matching (1:4) was performed to balance demographics and comorbidities. The primary outcome was all\u2010cause in\u2010hospital mortality; secondary outcomes included length of stay, hospitalization costs, mechanical ventilation, vasopressor use, and major adverse events.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of 1\u2009450\u2009860 CDI hospitalizations, 1600 (0.11%) had IPF. After matching, IPF was independently associated with higher in\u2010hospital mortality (aOR 1.85, 95% CI 1.22\u20132.76), longer hospital stays, and increased hospitalization costs. IPF patients were more likely to require mechanical ventilation (aOR 1.79, 95% CI 1.27\u20132.52). However, rates of fulminant CDI complications (severe sepsis, toxic megacolon, ileus, colectomy, ileostomy) were not significantly increased in the IPF cohort after matching.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Hospitalized CDI patients with IPF experience significantly higher mortality and resource utilization compared to those without IPF. The absence of increased fulminant CDI complications suggests that CDI may act as a marker of underlying disease severity in IPF rather than a direct cause of death. These findings highlight the need for risk stratification in CDI patients with chronic lung diseases.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jgh3.70416","type":"journal-article","created":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T05:37:29Z","timestamp":1778564249000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Outcomes of\n                    <i>Clostridium difficile<\/i>\n                    Infection in Patients With Idiopathic Pulmonary Fibrosis: Analysis of the Nationwide Inpatient Sample, 2016\u20132020"],"prefix":"10.1002","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6424-0957","authenticated-orcid":false,"given":"Chun Ho","family":"Szeto","sequence":"first","affiliation":[{"name":"Department of Internal Medicine Texas Tech University Health Science Center Permian Basin  Odessa Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gloria","family":"Erazo Montalvan","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Texas Tech University Health Science Center Permian Basin  Odessa Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0256-5705","authenticated-orcid":false,"given":"Chung Yin","family":"Tai","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Traumatology The University of Hong Kong  Pok Fu Lam Hong Kong"},{"name":"Library, The Education University of Hong Kong  Tai Po Hong Kong"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edgar","family":"Luna Landa","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Texas Tech University Health Science Center Permian Basin  Odessa Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Godfrey","family":"Tabowei","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Texas Tech University Health Science Center Permian Basin  Odessa Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raymond","family":"Wadie","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Cayuga Medical Center  Ithaca New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raghavendra","family":"Sanivarapu","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Texas Tech University Health Science Center Permian Basin  Odessa Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,5,11]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12931\u2010021\u201001791\u2010z"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.2009\u2010040GL"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.202202\u20100399ST"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejim.2007.04.024"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1801550"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrgastro.2010.190"},{"key":"e_1_2_9_8_1","unstructured":"\u201cHCUP\u2010US NIS Overview [Internet]\u201d[cited Feb 5 2026] https:\/\/hcup\u2010us.ahrq.gov\/nisoverview.jsp."},{"key":"e_1_2_9_9_1","unstructured":"CDC \u201cClassification of Diseases Functioning and Disability [Internet]\u201d2024 [cited Feb 5 2026]. 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