Evidence map›Paper›PMID 31932139›Full record

ArticleJournal of the American Medical Directors Association2020

Association Between Bisphosphonates and Hospitalized Clostridioides difficile Infection Among Frail Older Adults.

Kevin W McConeghy, Andrew R Zullo, Christine W Lary, Tingting Zhang, Yoojin Lee, Lori Daiello, Douglas P Kiel, Sarah Berry

Open access · greenAbstract read
In one paragraph

Article in Journal of the American Medical Directors Association, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.0field-weighted citation impact, top 63% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 1 citations in OpenAlex.

  1. Risk Factors for Hospital Readmission forPathogens (Basel, Switzerland) · 2022
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 4 institutions in 1 country.

Kevin W McConeghyCenter of Innovation Long-term Services and Support, Providence Veterans Affairs Medical Center, Providence, RI; School of Public Health Brown University, Providence, RI; University of Rhode Island, College of Pharmacy, Kingston, RI. Electronic address: Kevin.mcconeghy@va.gov.
Andrew R ZulloCenter of Innovation Long-term Services and Support, Providence Veterans Affairs Medical Center, Providence, RI; School of Public Health Brown University, Providence, RI.
Christine W LaryMaine Medical Center for Outcomes Research & Evaluation, Portland, ME.
Tingting ZhangCenter of Innovation Long-term Services and Support, Providence Veterans Affairs Medical Center, Providence, RI; School of Public Health Brown University, Providence, RI.
Yoojin LeeCenter of Innovation Long-term Services and Support, Providence Veterans Affairs Medical Center, Providence, RI; School of Public Health Brown University, Providence, RI.
Lori DaielloSchool of Public Health Brown University, Providence, RI.
Douglas P KielHebrew SeniorLife, Hinda and Arthur Marcus Institute for Aging Research, Boston, MA; Beth Israel Deaconess Medical Center & Harvard Medical School, Boston, MA.
Sarah BerryHebrew SeniorLife, Hinda and Arthur Marcus Institute for Aging Research, Boston, MA; Beth Israel Deaconess Medical Center & Harvard Medical School, Boston, MA.
Brown University · USBeth Israel Deaconess Medical Center · USMaine Medical Center · USUniversity of Rhode Island · US

Funding

VARIATIONS IN LIFE'S FINAL CHAPTERP01AG027296 · NIA · BROWN UNIVERSITY · PI AMAL N. TRIVEDI, Kali St. Marie Thomas · 2007 to 2026
$38.9M
A Clinical Prediction Tool to Guide Treatment of Osteoporosis in the Nursing HomeR01AG045441 · NIA · HEBREW REHABILITATION CENTER FOR AGED · PI BERRY, SARAH DYER · 2014 to 2017
$1.7M
NIA NIH HHS P01 AG027296NIA NIH HHS R01 AG045441
6 · The paper itself

Abstract

objectivesClostridioides difficile infection is a major source of morbidity and mortality among frail older adults, especially those in nursing homes (NHs). Safety reports have signaled that bisphosphonate use may be a contributing cause. We therefore evaluated the risk of C difficile hospitalization associated with oral bisphosphonate use in the NH.

designObservational, retrospective new-user cohort study.

settingThe cohort included US NH residents aged ≥65 years who became a long-stay resident (>100 days in the NH) between January 1, 2008 and December 31, 2009.

methodsWe conducted a study of NH residents using linked Medicare claims and Minimum Data Set records. Residents were new users of an oral bisphosphonate 1:1 matched to new calcitonin users ("active" comparator) on propensity scores controlling for more than 100 covariates. The outcome was risk of hospitalization for C difficile infection in a Cox proportional hazards model adjusted for previous antibiotic and proton pump inhibitor use.

resultsOur final analytical cohort included 17,753 bisphosphonate and 5348 calcitonin users. In the matched cohort, 84/5209 (1.6%) vs 71/5209 (1.4%) C difficile-related hospitalizations occurred in bisphosphonate and calcitonin users, respectively. We observed no significant difference in the risk of hospitalization among bisphosphonate users (hazard ratio: 1.11, 95% confidence interval: 0.80-1.51). Antibiotic and proton pump inhibitor exposure before and after osteoporosis treatment was also similar between bisphosphonate and calcitonin users. CONCLUSIONS AND IMPLICATIONS: C difficile infection should not be a consideration when prescribing bisphosphonates to frail older adults given the lack of a significant association.

Indexed as

ClostridioidesDiphosphonatesAgedCohort StudiesFrail ElderlyHumansMedicareRetrospective StudiesUnited StatesDiphosphonatesadverse drug reactionBisphosphonateClostridioides difficilenursing home

Identifiers

PMID31932139
PMCPMC8922243
OpenAlexW2999136028

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.