Volume 15, Number 3—March 2009
CME ACTIVITY - Research
Clinical Risk Factors for Severe Clostridium difficile–associated Disease
Timothy J. Henrich
, Douglas Krakower, Asaf Bitton, and Deborah S. Yokoe
, Douglas Krakower, Asaf Bitton, and Deborah S. Yokoe
Table 3
Univariate analysis results for 336 patients with and without severe CDAD, June 2005–May 2006*
| Variable | All patients, %† | Severe CDAD, % (n = 41)‡ | Nonsevere CDAD, % (n = 295) | OR§ | p value |
|---|---|---|---|---|---|
| Age >70 y | 38.7 | 63.4 | 35.3 | 3.18 | 0.001¶ |
| Female | 48.2 | 51.2 | 47.8 | 1.15 | 0.807 |
| Chemotherapy use§ | 16.1 | 9.8 | 16.9 | 0.53 | 0.343 |
| Corticosteroid use§ | 25.6 | 31.7 | 24.7 | 1.41 | 0.444 |
| Proton pump inhibitor use§ | 63.7 | 61.0 | 64.1 | 0.88 | 0.832 |
| H2 blocker use | 32.1 | 34.1 | 31.9 | 1.11 | 0.909 |
| Enteral feeding | 21.7 | 26.8 | 21.0 | 1.38 | 0.520 |
| Parenteral feeding | 3.3 | 2.4 | 3.4 | 0.71 | 1.000 |
| Cardiovascular disease | 41.7 | 53.7 | 40.0 | 1.74 | 0.135 |
| Pulmonary disease | 19.3 | 24.4 | 18.6 | 1.41 | 0.508 |
| Diabetes | 22.6 | 22.0 | 22.7 | 0.96 | 1.000 |
| Renal disease | 22.0 | 19.5 | 22.4 | 0.84 | 0.831 |
| Hemodialysis | 6.0 | 4.9 | 6.1 | 0.79 | 1.000 |
| Immunocompromised | 17.3 | 4.9 | 19.0 | 0.22 | 0.044¶ |
| Malignancy | 46.9 | 39.0 | 47.1 | 0.72 | 0.420 |
| Small bowel obstruction or ileus | 8.3 | 19.5 | 6.8 | 3.33 | 0.014¶ |
| Abnormal abdominal CT scan | 28.3 | 78.0 | 21.4 | 13.09 | <0.001¶ |
| Prior hospitalization | 39.9 | 56.1 | 37.6 | 2.12 | 0.036¶ |
| SNF/rehabilitation stay | 22.9 | 36.6 | 21.1 | 2.17 | 0.043¶ |
| Max glucose level >150 mg/dL | 49.1 | 70.7 | 46.1 | 2.83 | 0.005¶ |
| ALT >40 U/L | 23.1 | 28.2 | 22.3 | 1.37 | 0.540 |
| Min albumin level <2.5 g/dL | 27.7 | 59.0 | 22.8 | 4.89 | <0.001¶ |
| Max creatinine level >2 mg/dL | 22.0 | 41.5 | 19.3 | 2.96 | 0.003¶ |
| Max leukocyte count >20,000/μL | 28.3 | 53.7 | 24.7 | 3.52 | <0.001¶ |
| Mean max leukocyte count × 103/μL | 17.6 | 25.8 | 16.5 | – | <0.001¶ |
*CDAD, Clostridium difficile–associated disease; OR, odds ratio; H2, histamine-2; CT, computed tomography; SNF, skilled-nursing facility; max, maximum; ALT, alanine aminotransferase; min, minimum.
†Total of 336 patients were included in analysis except for ALT (n = 286) and albumin (n = 295).
‡n = 39 for ALT and albumin.
§OR for severe CDAD in patients with positive C. difficile assay results; calculated for binary variables only (by χ2 or Fisher exact test) with exception of mean leukocyte count (significance calculated using Mann-Whitney test of ranked data).
¶Statistically significant at α = 0.05.
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