Program

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Burden of Invasive Extraintestinal Pathogenic E. coli Disease Among Older Adult Patients Treated in Hospitals in the US

Speaker(s)

Hernandez-Pastor L1, Geurtsen J2, Baugh B3, El Khoury AC4, Kalu N4, Gauthier-Loiselle M5, Bungay R5, Cloutier M5
1Janssen Pharmaceutica NV, Beerse, Belgium, 2Janssen Vaccines & Prevention BV, Leiden, Netherlands, 3Janssen Research & Development, LLC, Raritan, NJ, USA, 4Janssen Scientific Affairs, LLC, Titusville, NJ, USA, 5Analysis Group, Inc., Montreal, QC, Canada

Presentation Documents

Objective: To describe medical resource utilization and costs associated with invasive extraintestinal pathogenic E. coli disease (IED) in older adults in the US.

Methods: Patients ≥60 years old with ≥1 IED hospital encounter were identified from the Premier Healthcare Database (10/01/2015-03/31/2020). The index encounter was defined as the first encounter with a positive E. coli culture in a normally sterile site (Group 1) or positive E. coli culture in urine with signs of sepsis (Group 2). Encounters with a positive culture from other bacteria or fungal pathogens were excluded. Outcomes were descriptively reported during the index encounter and over the subsequent year (post-index period). Medical resource utilization and costs included inpatient admissions and outpatient hospital services; costs were reported from a hospital’s perspective in 2021 USD.

Results: A total of 19,773 patients with IED were identified (Group 1: 51.8%; Group 2: 48.2%). Mean age was 76.8 years and 67.4% were female. Most index encounters had community-onset (94.3%) and led to inpatient hospitalization (96.5%; mean duration: 6.9 days), while 32.4% required transfer to an intensive care unit admission (mean duration: 3.7 days). In-hospital fatality rate was 6.8% during the index encounter and reached 10.9% at 1-year post-index. During the post-index period, 2.4% of patients had an IED recurrence and 36.8% had ≥1 all-cause hospitalization. Average all-cause medical costs amounted to $16,760 during the index encounter and $10,942 during the post-index period. Compared to Group 1, IED encounters from Group 2 were associated with higher all-cause medical costs during the index encounter ($18,536 vs $15,105, p<0.001); this difference was not statistically significant during the post-index period ($11,754 vs $10,186, p=0.204).

Conclusion: IED is associated with substantial clinical and economic burden both during the initial encounter and over the following year, highlighting the need and potential benefits of preventive management of IED.

Code

EE154

Topic

Economic Evaluation

Disease

Infectious Disease (non-vaccine)