Chest
Original ResearchCritical Care MedicineAnalysis of 30-Day Mortality for Clostridium difficile-Associated Disease in the ICU Setting
Section snippets
Study Location and Patients
This study was conducted at a university-affiliated, urban, teaching hospital: Barnes-Jewish Hospital (1,200 beds). During a 2-year period (January 2004 to December 2005), all patients in an ICU (medical, surgical, neurosurgical, cardiac, and cardiothoracic surgery) with a diagnosis of CDAD were eligible for this investigation. Patients with CDAD transferred to an ICU from another hospital, patients with a do-not-resuscitate order in their medical records, and those with a previous diagnosis of
Patients
A total of 289 consecutive patients with CDAD were initially evaluated. Eleven patients were excluded because of prior hospitalization for CDAD. The remaining 278 patients constituted the study cohort; of whom 102 patients (36.7%) died within 30 days of the diagnosis of CDAD. The mean age of the study patients was 63.9 ± 15.9 years (range, 17 to 96 years), and the average APACHE II score was 20.4 ± 6.4 (range, 5 to 38). There were 148 men (53.2%) and 130 women (46.8%); 196 patients (70.5%) were
Discussion
We observed a crude 30-day mortality rate of 36.7% for patients with CDAD in the ICU setting. We also identified potential risk factors for 30-day mortality among critically ill patients with CDAD, including greater severity of illness, the presence of septic shock, and having CDAD develop on the hospital ward prior to ICU transfer. CDAD was associated with a 6.1% attributable mortality rate and prolonged lengths of stay in the ICU and hospital. These findings suggest that mortality due to CDAD
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2022, Journal of the Neurological SciencesPrognostic factors for severe and recurrent Clostridioides difficile infection: a systematic review
2022, Clinical Microbiology and InfectionCitation Excerpt :No formal meta-analyses were performed since the definitions of the outcomes of interest (sCDI/rCDI), as well as the definitions of the prognostic factors used in the studies included in this review were highly heterogeneous, and due to incompletely reported effect estimates and different effect measures used across studies. The search for prognostic factors for sCDI yielded 1242 references; 126 studies were assessed in more detail, and 76 were included for analysis [20,24,25,29,40–110]; 12 more studies retrieved from cross-references were also included [111–122] resulting in 88 studies for final analysis (Fig. 1). The search for prognostic factors for rCDI yielded 1104 references; 105 studies were assessed in more detail, and 36 were included for analysis [9,10,12–15,59,103,110,118,123–148] as were seven studies from cross-references [112,149–154].
European Society of Clinical Microbiology and Infectious Diseases: 2021 update on the treatment guidance document for Clostridioides difficile infection in adults
2021, Clinical Microbiology and InfectionCharacteristics, risk factors and outcomes of Clostridium difficile infections in Greek Intensive Care Units
2019, Intensive and Critical Care NursingCitation Excerpt :Mortality in our group is similar with reports from other countries (Bouza et al., 2015; Karanika et al., 2016; Alvarez-Lerma et al. 2014). However, attributable mortality to CDI and the impact of CDI on length of stay are outcomes which are not so extensively researched (Kenneally et al., 2007; Yoon et al., 2014). It has been suggested that CDI is associated with increased risk for mortality up to more than 50%, while it may prolong the length of stay, although in the study by Dodek et al. no association of CDI with ICU or hospital mortality was found (Dodek et al., 2013; Karanika et al., 2016; Reacher et al., 2016).
The authors have no conflicts of interest to report for this work.