Background
The purpose of this study was to evaluate whether Clostridium difficile infection (CDI) contributed to hospital mortality and whether the correlation between
intensive care units (ICUs) and surgical wards in hospital CDI risk still remain controversial.
Methods
By meta-analysis, 12 eligible studies involving 8,509 cases and 247,285 controls were
identified via PubMed and Embase.
Results
CDI patients had a higher risk of hospital mortality than non-CDI patients (odds ratio
[OR], 1.899; 95% confidence interval [CI], 1.269-2.840), especially in 30-day mortality
(OR, 2.521; 95% CI, 1.800-3.531). No correlation was found between hospital CDI and
Charlson comorbidity index (OR, 0.830; 95% CI, 0.559-1.231). Patients treated in the
ICU have an increased risk of hospital CDI (OR, 1.820; 95% CI, 1.161-2.851). However,
the risk of CDI in patients who used to have surgery in surgical wards was not different
to patients in the other departments (OR, 1.054; 95% CI, 0.838-1.325). Moreover, CDI
patients in studies from the most recent 5 years have a higher risk of hospital mortality
(OR, 2.171; 95% CI, 1.426-3.304).
Conclusion
Hospital CDI was associated with an increased risk of hospital mortality, especially
in 30-day mortality. In addition, when compared with past years, CDI patients have
a higher risk of hospital mortality in the most recent 5 years. Given the rapid dissemination
of this organism worldwide, there is a need to aggressively develop and evaluate primary
preventive strategies targeting CDI among hospitalized patients, especially in ICUs.
Key Words
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Article info
Footnotes
Funding/Support: Supported by grants from the National Nature Science Foundation of China (no. 81172141, 81200401), Nanjing Science and Technology Committee Project (no. 201108025), Nanjing Medical Technology Development Project (no. ZKX11025), Nanjing Health Young Talent Project, Jiangsu Provincial Key Medical Talents to Wang, and Nanjing Medical Science and Technique Development Foundation to Pan (no. QRX11255) and He (no. QRX11254).
Author Contributions: Conceived and designed the experiments: Wang, Gao, Xia. Performed the experiments: Deng, Sun, Chen, and Liu. Analyzed the data: Gao. Contributed reagents/materials/analysis tools: Pan and He. Wrote the manuscript: Wang and Gao. Designed the software used in analysis: He.
Conflicts of interest: None to report.
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© 2015 Published by Elsevier Inc.
