ArticleBMJ open2015
Multimorbidity in elderly hospitalised patients and risk of Clostridium difficile infection: a retrospective study with the Cumulative Illness Rating Scale (CIRS).
Article in BMJ open, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 1 of them a synthesis that pooled it.
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Who cites it
22 citing papers in PubMed, 1 synthesis or guideline pooled it, 34 citations in OpenAlex.
- Magnitude and direction of the association between Clostridium difficile infection and proton pump inhibitors in adults and pediatric patients: a systematic review and meta-analysis.Journal of gastroenterology · 2018Pooled it
- Identification and Characterization of Patient Populations at High Risk for Clostridioides difficile Infection (CDI): A Narrative Review.Infectious diseases and therapy · 2026Review
- Development of a checklist to support management of older patients withBMJ open quality · 2026Article
- Healthcare-Associated Infections (HAIs) in the Elderly: Molecular Mechanisms of Immunosenescence and Clinical, Nutritional and Therapeutic Implications.International journal of molecular sciences · 2025Review
- Healthcare-associated infection and unfavourable outcomes during a one-year follow-up after discharge: a single-center study.International journal of occupational medicine and environmental health · 2025Article
- How to Assess Health Gains.Healthcare (Basel, Switzerland) · 2025Article
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- Article
- Recurrence of Clostridioides difficile infection and mortality in older inpatients.European geriatric medicine · 2024Article
- Impact of infection on healthcare costs and clinical outcomes in elderly hospitalized patients with multimorbidity.Heliyon · 2024Article
- Interaction of Clostridioides difficile infection with frailty and cognition in the elderly: a narrative review.European journal of medical research · 2023Review
- Assessment of independent comorbidities and comorbidity measures in predicting healthcare facility-onset Clostridioides difficile infection in Kenya.PLOS global public health · 2022Article
- Clinical characteristics and factors related to antibiotic-associated diarrhea in elderly patients with pneumonia: a retrospective cohort study.BMC geriatrics · 2021Article
- Application of The Sepsis-3 Consensus Criteria in a Geriatric Acute Care Unit: A Prospective Study.Journal of clinical medicine · 2019Article
- Digestive disorders and Intestinal microbiota.Acta bio-medica : Atenei Parmensis · 2018Review
- Increasing Age Has Limited Impact on Risk ofOpen forum infectious diseases · 2018Article
- Aging Gut Microbiota at the Cross-Road between Nutrition, Physical Frailty, and Sarcopenia: Is There a Gut-Muscle Axis?Nutrients · 2017Review
- Gut microbiota composition is associated with polypharmacy in elderly hospitalized patients.Scientific reports · 2017Article
- Impact of Underlying Conditions on Zoster-Related Pain and on Quality of Life Following Zoster.The journals of gerontology. Series A, Biological sciences and medical sciences · 2017Observational
- [Clostridium difficile infections in geriatric patients].Zeitschrift fur Gerontologie und Geriatrie · 2016Review
Corrections and comments
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Authors and funding
11 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesTo identify the role of chronic comorbidities, considered together in a literature-validated index (Cumulative Illness Rating Scale, CIRS), and antibiotic or proton-pump inhibitor (PPI) treatments as risk factors for hospital-acquired Clostridium difficile infection (CDI) in elderly multimorbid hospitalised patients.
designRetrospective cohort study.
settingSubacute hospital geriatric care ward in Italy.
participants505 (238 male (M), 268 female (F)) elderly (age≥65) multimorbid patients.
main outcome measuresThe relationship between CDI and CIRS Comorbidity Score, number of comorbidities, antibiotic, antifungal and PPI treatments, and length of hospital stay was assessed through age-adjusted and sex-adjusted and multivariate logistic regression models. The CIRS Comorbidity Score was handled after categorisation in quartiles.
resultsMean age was 80.7±11.3 years. 43 patients (22 M, 21 F) developed CDI. The prevalence of CDI increased among quartiles of CIRS Comorbidity Score (3.9% first quartile vs 11.1% fourth quartile, age-adjusted and sex-adjusted p=0.03). In the multivariate logistic regression analysis, patients in the highest quartile of CIRS Comorbidity Score (≥17) carried a significantly higher risk of CDI (OR 5.07, 95% CI 1.28 to 20.14, p=0.02) than patients in the lowest quartile (<9). The only other variable significantly associated with CDI was antibiotic therapy (OR 2.62, 95% CI 1.21 to 5.66, p=0.01). PPI treatment was not associated with CDI.
conclusionsMultimorbidity, measured through CIRS Comorbidity Score, is independently associated with the risk of CDI in a population of elderly patients with prolonged hospital stay.
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