Volume 14, Number 7—July 2008
Research
Attributable Outcomes of Endemic Clostridium difficile–associated Disease in Nonsurgical Patients
, Anne M. Butler*, Kimberly A. Reske*, Denis Agniel*, Margaret A. Olsen*, Gina D’Angelo*, L. Clifford McDonald†, and Victoria J. Fraser*
Table 3
Cox proportional hazards estimate of deaths from Clostridium difficile–associated disease (CDAD) at 180 d in study cohort (N = 18,050; 2,299 deaths, 15,751 censored)*†
| Variable | Univariate hazard ratio‡ (95% CI) | Multivariable hazard ratio‡ (95% CI) |
|---|---|---|
| CDAD | 3.55 (3.37–3.75) | 1.23 (1.03–1.46) |
| Male sex | 1.73 (1.68–1.77) | 1.17 (1.08–1.27) |
| White race |
1.65 (1.61–1.70) |
1.22 (1.11–1.33) |
| Modified APS | ||
| <2 | Reference | Reference |
| 3–4 | 1.41 (1.36–1.47) | 1.09 (0.96–1.24) |
| 5–6 | 2.09 (2.00–2.17) | 1.30 (1.14–1.49) |
| >7 |
4.11 (3.97–4.25) |
1.65 (1.46–1.87) |
| Albumin, g/dL§ | ||
| >3.5 | Reference | Reference |
| 2.5–3.5 | 2.12 (1.90–2.36) | 1.62 (1.45–1.82) |
| <2.5 |
4.77 (3.91–5.81) |
2.93 (2.52–3.42) |
| Liver disease | ||
| None | Reference | Reference |
| Mild | 3.08 (2.86–3.33) | 2.37 (1.85–3.04) |
| Moderate to severe |
5.50 (5.17–5.85) |
3.76 (3.05–4.64) |
| Diabetes with chronic complications | 1.47 (1.37–1.58) | 1.49 (1.18–1.88) |
| Congestive heart failure | 1.85 (1.80–1.91) | 1.28 (1.15–1.42) |
| Cerebrovascular disease | 1.68 (1.60–1.76) | 1.62 (1.37–1.92) |
| Cancer, excluding leukemia or lymphoma | 6.42 (6.24–6.61) | 2.44 (2.15–2.76) |
| Leukemia or lymphoma | 3.17 (2.99–3.38) | 4.92 (3.98–6.08) |
| Metastatic solid tumor | 8.82 (8.57–9.09) | 4.41 (3.87–5.03) |
| HIV/AIDS | 1.77 (1.62–1.95) | 2.88 (2.12–3.91) |
| Paraplegia/ hemiplegia | 1.75 (1.60–1.92) | 1.53 (1.12–2.07) |
| Mechanical ventilation | 6.39 (6.18–6.62) | 3.17 (2.71–3.71) |
| ICU admission | 3.08 (2.99–3.17) | 1.31 (1.14–1.50) |
*CI, confidence interval; APS, Acute Physiology Score; ICU, intensive care unit.
†Nonsignificant variables considered in the model included diabetes without chronic complications, chronic obstructive pulmonary disease, myocardial infarction, rheumatologic/collagen vascular disease and peptic ulcer disease. Of 2,299 people who died within 180 d of admission, 1,565 (68%) deaths were identified by means of the hospital Medical Informatics database and 734 (32%) were identified with the Social Security Death Index.
‡Hazard ratios also adjusted for categorical age (<20, 20–24, 25–29, 30–34, 35–39, 40–44, 45–49, 50–54, 55–59, 60–64, 65–69, 70–74, 75–79, 80–84, 85–89, 90–94, ≥95 y).
§7,525 (43%) patients were missing albumin values. Values were imputed by using multiple imputation methods.