ArticleAging clinical and experimental research2022
Does accepted definition of Clostridioides difficile infection (CDI) severity predict poor outcomes in older adults?
Article in Aging clinical and experimental research, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed, 3 citations in OpenAlex.
- Longitudinal trends in community-onset bacteraemia caused by ceftriaxone non-susceptibleJAC-antimicrobial resistance · 2026Article
- Frailty level at discharge predicts mortality in older patients with Clostridioides difficile more accurately than age or disease severity.European geriatric medicine · 2023Article
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8 authors at 1 institution in 1 country.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundAdvanced age is an important factor affecting Clostridioides difficile infection (CDI) risk and outcome. While fever and leukocytosis are prominent findings in young individuals with CDI, they are usually blunted in the elderly. Furthermore, chronic kidney disease often exists among this population prior to the CDI episode onset.
aimWe aimed to examine whether the accepted definition of severe CDI (leukocytosis ≥ 15,000 cells/μl or serum creatinine > 1.5 mg/dl) predicts poor outcomes in the elderly.
methodsAll CDI hospitalized individuals between January-2013 and May-2020 were included. The study population was dichotomized into older group (≥ 65 years) and younger group (< 65 years). Primary composite outcome was 30-day mortality, colectomy due to severe colitis, or intensive care unit admission. The older group was divided according to the primary outcome to evaluate the effect of CDI severity criteria.
resultsThe study included 853 patients. Of them, 571 were in the older group and 282 in the younger one. The primary outcome was significantly more common in the older group (93/571, 16% vs. 31/282, 11%; p = 0.04). Ninety days mortality was significantly higher in the older group [116/571, 20% vs. 30/282, 11%; p < 0.01]. In multivariate analysis, accepted CDI severity criteria were not significantly associated with poor outcomes (odds ratio [OR] = 1.2, 95% confidence interval [CI] 0.7-2.2, p = 0.5). Advanced dementia and low serum albumin were significant predictors of poor outcomes (OR = 3, 95%CI 1.5-6, p = 0.002 and OR = 3.1, 95%CI 1.7-5.8, p < 0.01).
conclusionThe accepted definition of CDI severity was not useful in predicting CDI poor outcomes in older adults. In this population, we suggest advanced dementia and low albumin among others as CDI severity markers.
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