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High delayed mortality after the first episode of Clostridium difficile infection

AuthorsCozar, Alberto; Ramos-Martínez, Antonio; Merino, Esperanza; Martinez-Garcia, Cristina; Shaw, Evelyn; Marrodán, Teresa; Calbo, Esther; Bereciartúa, Elena; Sánchez-Muñoz, Luis A.; Salavert, Miguel; Teresa Pérez-Rodríguez, M.; García, Dácil; Bravo-Ferrer, José; Gálvez-Acebal, Juan; Henríquez, César; Cuquet, Jordi; Gil-Campesino, Helena; Torres, Luis; Sánchez-Porto, Antonio; Royuela, Ana; Cobo Reinoso, Javier
KeywordsClostridium difficile
Fecal incontinence
Issue Date2019
CitationAnaerobe 57: 93-98 (2019)
AbstractClostridium difficile infection (CDI) is characterized by a high delayed and unrelated mortality. Predicting delayed mortality in CDI patients could allow the implementation of interventions that could reduce these events. A prospective multicentric study was carried out to investigate prognostic factors associated with mortality. It was based on a cohort (July 2015 to February 2016) of 295 patients presenting with CDI. Logistic regression was used and the model was calibrated using the Hosmer-Lemeshow test. The mortality rate at 75 days in our series was 18%. Age (>65 years), comorbidity (defined by heart failure, diabetes mellitus with any organ lesion, renal failure, active neoplasia or immunosuppression) and fecal incontinence at clinical presentation were associated with delayed (75-day) mortality. When present, each of the aforementioned variables added one point to the score. Mortalities with 0, 1, 2 and 3 points were 0%, 9.4%, 18.5% and 38.2%, respectively. The area under the ROC curve was 0.743, and the Hosmer-Lemeshow goodness-of-fit test p value was 0.875. Therefore, the prediction of high delayed mortality in CDI patients by our scoring system could promote measures for increasing survival in suitable cases.
DescriptionStudy group: José Romero; Alfonso Muriel; Livia Giner; Federico Ferrere; Rocío Martínez-Ruiz; Purificación Martos; Cristina Sardiña; Elena Aguirre; Cristina Badía; Alfonso Perales; Pedro A. De Santos-Castro; Angel Bratos-Pérez Miguel; Sandra Cuellar; Eva González; Pedro llinares; Laura Castelo; Isabel Morales; Alberto Delgado-Iribarren; Pilar Mairal
Publisher version (URL)https://doi.org/10.1016/j.anaerobe.2019.04.004
Identifiersdoi: 10.1016/j.anaerobe.2019.04.004
issn: 1075-9964
e-issn: 1095-8274
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