TY - JOUR
T1 - Predictors of Clostridium difficile infection–related mortality among older adults
AU - Chopra, Teena
AU - Awali, Reda A.
AU - Biedron, Caitlin
AU - Vallin, Eileen
AU - Bheemreddy, Suchitha
AU - Saddler, Christopher M.
AU - Mullins, Keith
AU - Echaiz, Jose F.
AU - Bernabela, Luigino
AU - Severson, Richard
AU - Marchaim, Dror
AU - Lephart, Paul
AU - Johnson, Laura
AU - Thyagarajan, Rama
AU - Kaye, Keith S.
AU - Alangaden, George
N1 - Publisher Copyright:
© 2016 Association for Professionals in Infection Control and Epidemiology, Inc.
PY - 2016/11/1
Y1 - 2016/11/1
N2 - Background Over 90% of annual deaths caused by Clostridium difficile infection (CDI) occur in persons aged ≥65 years. However, no large-scale studies have been conducted to investigate predictors of CDI-related mortality among older adults. Methods This case-control study included 540 CDI patients aged ≥60 years admitted to a tertiary care hospital in Detroit, Michigan, between January 2005 and December 2012. Cases were CDI patients who died within 30 days of CDI date. Controls were CDI patients who survived >30 days after CDI date. Cases were matched to controls on a 1:3 ratio based on age and hospital acquisition of CDI. Results One-hundred and thirty cases (25%) were compared with 405 controls (75%). Independent predictors of CDI-related mortality included admission from another acute hospital (odds ratio [OR], 8.25; P = .001) or a long-term care facility (OR, 13.12; P = .012), McCabe score ≥2 (OR, 12.19; P < .001), and high serum creatinine (≥1.7 mg/dL) (OR, 3.43; P = .021). The regression model was adjusted for the confounding effect of limited activity of daily living score, total number of antibiotic days prior to CDI, ileus on abdominal radiograph, low albumin (≤2.5 g/dL), elevated white blood cell count (>15 × 1,000/mm3), and admission to intensive care unit because of CDI. Conclusions Predictors of CDI-related mortality reported in this study could be applied to the development of a bedside scoring system for older adults with CDI.
AB - Background Over 90% of annual deaths caused by Clostridium difficile infection (CDI) occur in persons aged ≥65 years. However, no large-scale studies have been conducted to investigate predictors of CDI-related mortality among older adults. Methods This case-control study included 540 CDI patients aged ≥60 years admitted to a tertiary care hospital in Detroit, Michigan, between January 2005 and December 2012. Cases were CDI patients who died within 30 days of CDI date. Controls were CDI patients who survived >30 days after CDI date. Cases were matched to controls on a 1:3 ratio based on age and hospital acquisition of CDI. Results One-hundred and thirty cases (25%) were compared with 405 controls (75%). Independent predictors of CDI-related mortality included admission from another acute hospital (odds ratio [OR], 8.25; P = .001) or a long-term care facility (OR, 13.12; P = .012), McCabe score ≥2 (OR, 12.19; P < .001), and high serum creatinine (≥1.7 mg/dL) (OR, 3.43; P = .021). The regression model was adjusted for the confounding effect of limited activity of daily living score, total number of antibiotic days prior to CDI, ileus on abdominal radiograph, low albumin (≤2.5 g/dL), elevated white blood cell count (>15 × 1,000/mm3), and admission to intensive care unit because of CDI. Conclusions Predictors of CDI-related mortality reported in this study could be applied to the development of a bedside scoring system for older adults with CDI.
KW - Clostridium difficile
KW - mortality
KW - older adults
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U2 - 10.1016/j.ajic.2016.04.231
DO - 10.1016/j.ajic.2016.04.231
M3 - Article
C2 - 27424303
AN - SCOPUS:84979593611
SN - 0196-6553
VL - 44
SP - 1219
EP - 1223
JO - American Journal of Infection Control
JF - American Journal of Infection Control
IS - 11
ER -