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Volume 14, Number 7—July 2008
Research

Attributable Outcomes of Endemic Clostridium difficile–associated Disease in Nonsurgical Patients

Erik R. Dubberke*Comments to Author , Anne M. Butler*, Kimberly A. Reske*, Denis Agniel*, Margaret A. Olsen*, Gina D’Angelo*, L. Clifford McDonald†, and Victoria J. Fraser*
Author affiliations: *Washington University School of Medicine, St. Louis, Missouri, USA; †Centers for Disease Control and Prevention, Atlanta, Georgia, USA;

Main Article

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.

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Page created: July 12, 2010
Page updated: July 12, 2010
Page reviewed: July 12, 2010
The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.
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