Abstract
Identifying patients who are at high risk for severe Clostridium difficile-associated disease (CDAD) early in the course of their infection may help clinicians improve outcomes. Therefore, we compared clinical features associated with severe versus nonsevere CDAD by retrospectively reviewing records of hospitalized patients whose fecal assays were positive for C. difficile toxin. Of 336 patients, 12.2% had severe disease and 10.1% died from all causes. Regression modeling showed the following to be significantly associated with severe CDAD (p< or =0.05): age >70 years (odds ratio [OR] 3.35), maximum leukocyte count >20,000 cells/mL (OR 2.77), minimum albumin level <2.5 g/dL (OR 3.44), maximum creatinine level >2 mg/dL (OR 2.47), small bowel obstruction or ileus (OR 3.06), and computed tomography scan showing colorectal inflammation (OR 13.54). These clinical and laboratory markers for severe disease may be useful for identifying patients at risk for serious outcomes or death.
Highlights
Upon completion of this activity, participants will be able to: Identify the criteria used to define severe Clostridium difficile–associated disease (CDAD) in the current study Specify the prevalence of severe CDAD in the current study Identify the clinical risk factors for severe CDAD List the laboratory risk factors for severe CDAD
As would be expected in a general hospitalized population, advanced age was associated with all-cause mortality rates
Advanced age is known to be associated with CDAD, but whether age influences the severity of disease outcomes is in conflict in different publications [3,6,12]
Summary
Disclosure: Lynne Stockton has disclosed no relevant financial relationships. Regression modeling showed the following to be significantly associated with severe CDAD (p70 years (odds ratio [OR] 3.35), maximum leukocyte count >20,000 cells/mL (OR 2.77), minimum albumin level 2 mg/dL (OR 2.47), small bowel obstruction or ileus (OR 3.06), and computed tomography scan showing colorectal inflammation (OR 13.54). These clinical and laboratory markers for severe disease
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