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 2
Cox proportional hazards estimate of readmission at 180 d in Clostridium difficile–associated disease (CDAD) study cohort (N = 17,492; 4m207 readmissions, 13,285 censored)*†
| Variable | Univariate hazard ratio‡ (95% CI) | Multivariable hazard ratio ‡ (95% CI) |
|---|---|---|
| CDAD | 3.09 (2.95–3.23) | 2.19 (1.87–2.55) |
| Male sex | 1.42 (1.40–1.45) | 1.11 (1.05–1.19) |
| White race |
1.26 (1.23–1.28) |
1.06 (1.00–1.13) |
| Modified APS | ||
| <2 | Reference | Reference |
| 3–4 | 1.15 (1.12–1.18) | 1.10 (1.02–1.20) |
| 5–6 | 1.39 (1.35–1.43) | 1.24 (1.13–1.35) |
| >7 |
1.84 (1.80–1.89) |
1.50 (1.37–1.64) |
| Albumin, g/dL§ | ||
| >3.5 | Reference | Reference |
| 2.5–3.5 | 1.05 (1.03–1.08) | 0.99 (0.92–1.08) |
| <2.5 |
1.03 (0.99–1.07) |
0.95 (0.80–1.14) |
| Liver disease | ||
| None | Reference | Reference |
| Mild | 1.80 (1.67–1.94) | 1.44 (1.12–1.83) |
| Moderate to severe |
1.79 (1.65–1.94) |
1.48 (1.13–1.93) |
| Diabetes with chronic complications | 1.89 (1.80–1.99) | 1.53 (1.30–1.80) |
| Diabetes without chronic complications |
1.29 (1.26–1.32) |
1.10 (1.02–1.19) |
| Congestive heart failure | 1.60 (1.56–1.64) | 1.34 (1.23–1.45) |
| Cerebrovascular disease | 0.77 (0.74–0.81) | 0.74 (0.63–0.87) |
| Cancer, excluding leukemia or lymphoma | 2.75 (2.67–2.83) | 1.90 (1.70–2.13) |
| Leukemia or lymphoma | 2.31 (2.18–2.45) | 1.84 (1.52–2.23) |
| Metastatic solid tumor | 2.81 (2.71–2.91) | 1.66 (1.46–1.90) |
| HIV/AIDS | 1.74 (1.62–1.87) | 1.74 (1.38–2.19) |
| ICU admission | 1.06 (1.03–1.09) | 0.84 (0.76–0.93) |
*CI, confidence interval; APS, Acute Physiology Score; ICU, intensive care unit.
†The analysis excluded 558 patients who died during the index hospital admission. Nonsignificant variables considered in the model included mechanical ventilation, paraplegia/hemiplegia, chronic obstructive pulmonary disease, myocardial infarction, rheumatologic/collagen vascular disease, and peptic ulcer disease.
‡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).
§7,610 (42%) patients were missing albumin values. Values were imputed by using multiple imputation methods.