Table 2.
Risk factors for unfavourable outcome of CDAD
| Variable | Favorable | Unfavourable | Univariate analysis | Multivariate analysis | ||
|---|---|---|---|---|---|---|
| (N = 162) | (N = 48) | p | OR (95% CI) | p | OR (95% CI) | |
| Demographic characteristics | ||||||
| Median age [years (IQR)] | 67 (57–75) | 76 (58–81) | 0.007 | 1.03 (1.00-1.05) | 0.046 | 1.12 (1.00-1.25) |
| Female gender [n (%)] | 86 (53.09) | 24 (50) | 0.707 | 0.88 (0.44-1.77) | ||
| Urban area [n (%)] | 118 (72.84) | 28 (58.33) | 0,055 | 1.92 (0.93-3.94) | ||
| Clinical and evolutive characteristics | ||||||
| Nosocomial infection with CD [n (%)] | 156 (96.30) | 48 (100) | 0.340 | 0.00 (0–2.87) | ||
| Relapses [n (%)] | 30 (18.52) | 12 (25) | 0.324 | 1.47 (0.64-3.35) | ||
| Median no. of hospitalization days for CDAD [days (IQR)] | 10 (8–13) | 4 (2.5-12.5) | 0.002 | 0.88 (0.82-0.95) | ||
| Median no. of leukocytes [cells/μl (IQR)] | 9565 (7210–32400) | 16100 (7120–20135) | <0.001 | 1.00 (1.0001-1.0002) | ||
| Leukocytosis ≥ 16000 cells/μl [n (%)] | 19 (11.73) | 25 (52.08) | <0.001 | 8.18 (3.67-18.43) | ||
| Hypoalbuminemia < 3.5 g/dl [n (%)] | 119 (73.46) | 47 (97.92) | <0.001 | 16.98 (2.70-700.55) | ||
| Fever > 37.5°C [n (%)] | 21 (12.96) | 31 (64.58) | <0.001 | 12.24 (5.45-27.88) | ||
| Median ATLAS Score (IQR) | 2 (1–3) | 5 (4–6) | <0.001 | 2.72 (2.02-3.67) | <0.001 | 4.97 (2.12-11.66) |
| Mild clinical form [n (%)] | 7 (4.32) | 0 (0) | 0.355 | 0.00 (0.00-2.33) | ||
| Moderate clinical form [n (%)] | 150 (92.59) | 3 (6.25) | <0.001 | 0.01 (0.00-0.02) | ||
| Sever clinical form [n (%)] | 5 (3.09) | 45 (93.75) | <0.001 | 471 (94.88-2836.91) | ||
| Comorbidities | ||||||
| Median Charlson comorbidity index score (IQR) | 2 (1–3) | 4 (3–5.5) | <0.001 | 1.48 (1.26-1.73) | ||
| Median Charlson comorbidity index score adjusted for age (IQR) | 4.5 (2–6) | 7 (5.5-8.5) | <0.001 | 1.40 (1.22-1.60) | ||
| Malignancy [n (%)] | 31 (19.14) | 13 (27.08) | 0.234 | 1.57 (0.69-3.52) | ||
| Colorectal cancer [n (%)] | 5 (3.09) | 0 (0) | 0.590 | 0.00 (0.00-3.70) | ||
| Diabetes mellitus [n (%)] | 35 (21.61) | 13 (27.08) | 0.427 | 1.35 (0.60-2.99) | ||
| Renal disease [n (%)] | 35 (21.61) | 12 (25) | 0.620 | 1.21 (0.53-2.72) | ||
| Chronic renal failure [n (%)] | 23 (14.20) | 12 (25) | 0.078 | 2.01 (0.85-4.73) | ||
| Chronic heart disease [n (%)] | 80 (49.38) | 31 (64.58) | 0.064 | 1.87 (0.91-3.85) | ||
| Peripheral vascular disease [n (%)] | 28 (17.28) | 12 (25) | 0.231 | 1.60 (0.69-3.66) | ||
| Dementia [n (%)] | 7 (4.32) | 3 (6.25) | 0.699 | 1.48 (0.24-6.78) | ||
| Cerebrovascular disease [n (%)] | 37 (22.84) | 18 (37.50) | 0.042 | 2.03 (0.96-4.27) | ||
| Chronic pulmonary pathology [n (%)] | 23 (14.20) | 15 (31.25) | 0.007 | 2.75 (1.21-6.22) | ||
| Moderate/severe liver pathology [n (%)] | 15 (9.26) | 11 (22.92) | 0.011 | 2.91 (1.14-7.43) | ||
| Gastrointestinal ulcer [n (%)] | 16 (9.88) | 7 (14.58) | 0.359 | 1.56 (0.54-4.38) | ||
| Inflammatory bowel disease [n (%)] | 4 (2.47) | 1 (2.08) | 1 | 0.84 (0.02-8.77) | ||
| Haematological pathology [n (%)] | 2 (1.23) | 4 (8.33) | 0.025 | 7.27 (0.99-81.83) | ||
| Concomitant infections [n (%)] | 44 (27.16) | 16 (33.33) | 0.405 | 1.34 (0.63-2.83) | ||
| Risk factors for CDAD in the past 2 months | ||||||
| Chemotherapy [n (%)] | 7 (4.32) | 7 (14.58) | 0.020 | 3.78 (1.11-12.87) | ||
| Radiotherapy [n (%)] | 5 (3.09) | 2 (4.17) | 0.660 | 1.37 (0.13-8.67) | ||
| Corticotherapy [n (%)] | 9 (5.56) | 6 (12.5) | 0.115 | 2.43 (0.67-8.11) | ||
| Dialysis [n (%)] | 6 (3.70) | 1 (2.08) | 1 | 0.55 (0.01-4.75) | ||
| Surgery [n (%)] | 82 (50.62) | 15 (31.25) | 0.018 | 0.44 (0.21-0.92) | ||
| Gastro-intestinal/abdominal surgery [n (%)] | 37 (22.84) | 6 (12.5) | 0.118 | 0.48 (0.17-1.30) | ||
| Enteral feeding [n (%)] | 1 (0.62) | 3 (6.25) | 0.038 | 10.73 (0.83-566.82) | ||
| Parenteral feeding [n (%)] | 5 (3.09) | 17 (35.42) | <0.001 | 17.22 (5.47-62.96) | ||
| Prior antibiotic treatment [n (%)] | 115 (70.99) | 30 (62.50) | 0.264 | 1.47 (0.71-3.04) | ||
| Intestinal motility inhibitors after CDAD onset | 17 (10.49) | 3 (6.25) | 0.576 | 0.57 (0.10-2.10) | ||
| Proton pump inhibitors after CDAD onset [n (%)] | 16 (9.88) | 6 (12.5) | 0.602 | 1.30 (0.39-3.78) | ||
| Other antacids after CDAD onset [n (%)] | 45 (27.78) | 20 (41.67) | 0.067 | 1.86 (0.90-3.82) | ||
| Antibiotic use after CDAD diagnosis (other than for CDAD) [n (%)] | 15 (9.26) | 17 (35.42) | <0.001 | 5.37 (2.26-12.84) | ||
| Median no. days of antibiotherapy after onset of episode (other than the treatment for CDAD) | 0 (0–0) | 0 (0–3) | 0.017 | 1.09 (1.01-1.18) | ||
| Median no. antibiotics after onset of episode (other than the treatment for CDAD) [no. (IQR)] | 0 (0–0) | 0 (0–1) | 0.002 | 1.74 (1.21-2.50) | 0.047 | 2.69 (1.01-7.17) |
| Treatment for CDAD | ||||||
| Metronidazole [n (%)] | 36 (22.22) | 6 (12.5) | 0.139 | 0.50 (0.16-1.32) | ||
| Vancomycin [n (%)] | 47 (29.01) | 11 (22.92) | 0.406 | 0.73 (0.32-1.63) | ||
| Vancomycin + Metronidazole [n (%)] | 71 (43.83) | 28 (58.33) | 0.077 | 1.79 (0.89-3.63) | ||
| Rifaximin - α (alone or in combination) [n (%)] | 8 (4.93) | 1 (2.08) | 0.687 | 0.41(0.01-3.20) | ||