It is interesting that the time when patients were evaluated using the Charlson Comorbidity Index was not mentioned in the study by Pepin and colleagues.1 It is possible that Clostridium difficile infections occurred in patients who were in a more serious condition; evaluation of the baseline characteristics of the 2 patient groups would have been best done 48 to 72 hours before the diagnosis of C. difficile-associated disease (CDAD) was made.
REFERENCE
- 1. Pépin J, Valiquette L, Cossette B. Mortality attributable to nosocomial Clostridium difficile-associated disease during an epidemic caused by a hypervirulent strain in Quebec. CMAJ 2005;173(9):1037-42. [DOI] [PMC free article] [PubMed]