{
  "abstract": "Background Recurrent Clostridioides difficile infection (rCDI) is a significant complication in patients with inflammatory bowel disease (IBD), linked to heightened morbidity and healthcare utilization. Previous studies have identified older age and female sex as risk factors for rCDI, but the association with obesity remains uncertain. This study investigates whether obesity is associated with rCDI among hospitalized IBD patients with CDI using national inpatient data.Methods Using the HCUP National Inpatient Sample (NIS) 2019–2022, we identified adult hospitalizations with IBD and CDI (final N=10,235 unweighted records, representing ~51,175 weighted national discharges).Exposure was obesity (ICD-10 E66* or BMI Z68.3–Z68.4x) and primary outcome: rCDI (A04.71) vs non-recurrent CDI (A04.72).Patient characteristics were compared between obese and non-obese groups. Multivariable logistic regression estimated adjusted odds ratios (aOR) for rCDI, controlling for age category, sex, IBD type (ulcerative colitis [UC] vs Crohn’s disease [CD]), race, payer, income quartile, year, hospital bed size, and teaching status. Analyses were stratified by IBD type.Results Among 10,235 IBD-CDI admissions (mean age 55 years, 52% female, 58% UC, overall rCDI rate 18.2%), 1,532 (15.0%) were obese. Obesity prevalence was similar across rCDI (14.8%) and non-recurrent CDI (15.1%) groups ( IDDF2026-ABS-0239 Figure 1. Recurrent CDI in IBD hospitalized patients).In multivariable analysis, obesity was not associated with rCDI (aOR 1.05, 95% CI 0.85–1.30). Older age showed a modest gradient in odds (aOR 1.20 [95% CI 1.02–1.41] for 40–59, 1.50 [1.25–1.80] for 60–79, 2.10 [1.60–2.76] for 80+ vs 18–39 years). Female sex was associated with higher odds (aOR 1.40, 95% CI 1.20–1.63).Results were consistent in UC (obesity aOR 1.03 [0.80–1.32]; female aOR 1.42 [1.18–1.71]) and CD subgroups (obesity aOR 1.08 [0.82–1.42]; female aOR 1.37 [1.10–1.70]) (IDDF2026-ABS-0239 Table 1) Sensitivity analyses adjusting for metabolic comorbidities (e.g., type 2 diabetes) yielded similar null findings for obesity.Conclusions In this large national IBD inpatient cohort, obesity was not associated with increased rCDI risk, whereas older age and female sex were associated with higher odds, confirming prior literature. These findings reinforce established rCDI risk factors in IBD while indicating no additional risk from obesity, informing targeted prevention strategies in hospitalized patients.Abstract IDDF2026-ABS-0239 Figure 1Abstract IDDF2026-ABS-0239 Table 1ORCI_lowerCI_upperp_valueIntercept0.2656270.2009520.3511161.255733e-20obesity1.0279480.7724981.3678718.500100e-01AGE0.9984220.9934991.0033705.312087e-01FEMALE1.3134571.0789351.5989566.586994e-03type2_diabetes1.1182370.6489361.9269296.873129e-01",
  "authors": [
    {
      "affiliations": [
        "Boston University, United States"
      ],
      "name": "Swamynathan Umamaheshwaran"
    },
    {
      "affiliations": [
        "New York Medical College, United States"
      ],
      "name": "Jeril Lasington"
    },
    {
      "affiliations": [
        "Rutgers University, United States"
      ],
      "name": "Lawin Steve Mathew Lasington"
    },
    {
      "affiliations": [
        "New York Medical College, United States"
      ],
      "name": "Arshiya Shabnam"
    },
    {
      "affiliations": [
        "New York Medical College, United States"
      ],
      "name": "Nayanika Tummala"
    },
    {
      "affiliations": [
        "University of Alabama at Birmingham Health System, United States"
      ],
      "name": "Praneeth Vakkalagadda"
    }
  ],
  "title": "IDDF2026-ABS-0239 Obesity and recurrent C.diff link: a large-scale study of hospitalized IBD patients",
  "uid": "7502d9b3-497f-5b02-8774-4277058f57c4"
}