Table 1.
Association between Baseline Characteristics and 60-Day CDI Recurrence in the Derivation Cohort (n=7538)
| Characteristic | No 60-Day CDI Recurrence (n=6315) |
60-Day CDI Recurrence (n=1223) |
p Value |
|---|---|---|---|
| Age (yrs), median (IQR) | 65 (59 – 76) | 66 (60 – 76) | 0.1195 |
| Age ≥ 65 yrs | 3347 (53.0) | 681 (55.7) | 0.0845 |
| Male sex | 6031 (95.5) | 1151 (94.1) | 0.0357 |
| Race-ethnicity | 0.0007 | ||
| Non-Hispanic white | 4092 (64.8) | 863 (70.6) | |
| Non-Hispanic black | 1459 (23.1) | 248 (20.3) | |
| Hispanic | 379 (6.0) | 48 (3.9) | |
| Other | 221 (3.5) | 37 (3.0) | |
| Missing | 164 (2.6) | 26 (2.1) | |
| Principal CDI diagnosis | 1768 (28.0) | 433 (35.4) | <0.0001 |
| Hospital LOS ≥14 days | 3094 (49.0) | 632 (51.7) | <0.00763 |
| Community-onset CDI | 2463 (39.0) | 795 (65.0) | <0.0001 |
| Comorbidities | |||
| Hypertension | 4913 (77.8) | 936 (76.5) | 0.3043 |
| Dyslipidemia | 3524 (55.8) | 733 (59.9) | 0.0062 |
| Obesity | 1175 (18.6) | 247 (20.2) | 0.2055 |
| Prior myocardial infarction | 701 (11.1) | 125 (10.2) | 0.3446 |
| Congestive heart failure | 1522 (24.1) | 295 (24.1) | 0.9921 |
| Peripheral vascular disease | 1194 (18.9) | 230 (18.8) | 0.8928 |
| Cerebrovascular disease | 1250 (19.8) | 220 (18.0) | 0.1213 |
| Dementia | 208 (3.3) | 27 (2.2) | 0.0429 |
| COPD | 2235 (35.4) | 461 (37.7) | 0.1196 |
| Rheumatologic disease | 158 (2.5) | 42 (3.4) | 0.0766 |
| Peptic ulcer disease | 278 (4.4) | 49 (4.0) | 0.5038 |
| Liver disease | 417 (6.6) | 84 (6.9) | 0.6607 |
| Diabetes mellitus | 2633 (41.7) | 495 (40.5) | 0.4277 |
| Hemiplegia or paraplegia | 284 (4.5) | 38 (3.1) | 0.0222 |
| Renal disease | 1661 (26.3) | 333 (27.2) | 0.4892 |
| Cancer | 1604 (25.4) | 300 (24.5) | 0.5207 |
| HIV/AIDS | 114 (1.8) | 21 (1.7) | 0.8537 |
| GERD | 1749 (27.7) | 388 (31.7) | 0.0048 |
| Transplant | 114 (1.8) | 34 (2.8) | 0.0270 |
| Inflammatory bowel disease | 139 (2.2) | 57 (4.7) | <0.0001 |
| Irritable bowel syndrome | 76 (1.2) | 20 (1.6) | 0.2793 |
| Charlson Comorbidity Index score, median (IQR) | 3 (1 – 6) | 3 (1 – 5) | |
| Any severe CDI | 4098 (64.9) | 564 (46.1) | <0.0001 |
| CDI severity indicators | |||
| ICU admission | 158 (2.5) | 12 (1.0) | 0.0004 |
| Sepsis/septicemia | 871 (13.8) | 108 (8.8) | <0.0001 |
| Shock | 189 (3.0) | 21 (1.7) | 0.0070 |
| Acute renal failure | 1711 (27.1) | 227 (18.6) | <0.0001 |
| Megacolon | 19 (0.3) | 1 (0.1) | 0.1292 |
| Prolonged ileus | 272 (4.3) | 32 (2.6) | 0.0022 |
| Perforated intestine | 25 (0.4) | 4 (0.3) | 0.6744 |
| White blood cell count ≥ 15 × 103/mm3 | 2305 (36.5) | 286 (23.4) | <0.0001 |
| C-reactive protein ≥ 160 mg/L | 95 (1.5) | 7 (0.6) | 0.0027 |
| Albumin < 2.5 g/dL | 1749 (27.7) | 146 (11.9) | <0.0001 |
| Serum creatinine >1.5 mg/dL | 1377 (21.8) | 249 (20.4) | 0.2477 |
| Colectomy | 6 (0.1) | 0 (0.0) | 0.2129 |
| Prior medications | |||
| Antibiotics | 3404 (53.9) | 758 (62.0) | <0.0001 |
| Penicillins | 1478 (23.4) | 338 (27.6) | 0.0018 |
| First- and second-generation cephalosporins | 644 (10.2) | 149 (12.2) | 0.0021 |
| Third- and fourth-generation cephalosporins | 720 (11.4) | 196 (16.0) | <0.0001 |
| Carbapenems | 227 (3.6) | 56 (4.6) | 0.0932 |
| Macrolides | 512 (8.1) | 122 (10.0) | 0.0372 |
| Fluoroquinolones | 1718 (27.2) | 408 (33.4) | <0.0001 |
| Aminoglycosides | 145 (2.3) | 43 (3.5) | 0.0191 |
| Tetracyclines | 202 (3.2) | 45 (3.7) | 0.4141 |
| Clindamycin | 474 (7.5) | 114 (9.3) | 0.0298 |
| Other | 1465 (23.2) | 330 (27.0) | 0.0044 |
| High-risk antibiotics | 2248 (35.6) | 543 (44.4) | <0.0001 |
| Narcotics | 2450 (38.8) | 505 (41.3) | 0.1073 |
| Antidiarrheals | 461 (7.3) | 150 (12.3) | <0.0001 |
| Laxatives | 2431 (38.5) | 488 (39.9) | 0.3428 |
| GAS | 3499 (55.4) | 459 (62.1) | <0.0001 |
| PPIs | 2924 (46.3) | 669 (54.7) | <0.0001 |
| H2RAs | 916 (14.5) | 179 (14.6) | 0.9080 |
| Other | 701 (11.1) | 158 (12.9) | 0.0729 |
| CDI therapies | |||
| Metronidazole | 4831 (76.5) | 631 (51.6) | <0.0001 |
| Vancomycin | 2172 (34.4) | 350 (28.6) | <0.0001 |
| Fidaxomicin | 44 (0.7) | 49 (4.0) | 0.1788 |
| Probiotics | 1572 (24.9) | 171 (14.0) | <0.0001 |
Data are no. (%) of patients unless otherwise specified.
AIDS=acquired immune deficiency syndrome; CDI=Clostridium difficile infection; CI=confidence interval; COPD=chronic obstructive pulmonary disease; GAS=gastric acid–suppressing; GERD=gastroesophageal reflux disease; HIV=human immunodeficiency syndrome; H2RAs=histamine2 receptor antagonists; ICU=intensive care unit; IQR=interquartile range; LOS=length of stay; PPIs=proton pump inhibitors.