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.
Key Words
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Article Info
Publication History
Published online: July 13, 2016
Footnotes
Conflicts of Interest: None to report.
Additional Information: The corresponding author, Reda A. Awali author had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.
Identification
Copyright
© 2016 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.
