Table 4.
Unadjusted Analysis for Predictors of Being Prescribed Guideline-Adherent Therapy Among Severe Clostridioides difficile Infection Cases (n = 3121)*
| Non-guideline-adherent therapy (n = 1641) N (%) |
Guideline-adherent therapy (n = 1480) N (%) |
Unadjusted odds ratio (95% confidence interval) | p value | |
|---|---|---|---|---|
| Sex | ||||
| Male | 655 (40) | 579 (39) | Reference | |
| Female | 986 (60) | 901 (61) | 1.04 (0.90, 1.20) | 0.63 |
| Age (years) | ||||
| 18–44 | 292 (18) | 208 (14) | Reference | |
| 45–64 | 484 (29) | 382 (26) | 1.12 (0.90, 1.41) | 0.31 |
| ≥ 65 | 865 (53) | 890 (60) | 1.33 (1.21, 1.82) | < 0.001 |
| Race | ||||
| White | 1342 (82) | 1240 (84) | Reference | |
| Non-white | 299 (18) | 240 (16) | 0.87 (0.72, 1.06) | 0.17 |
| Charlson comorbidity index | ||||
| 0 | 483 (29) | 328 (22) | Reference | |
| 1–2 | 536 (33) | 502 (34) | 1.37 (1.13, 1.65) | 0.001 |
| ≥ 3 | 622 (38) | 650 (44) | 1.54 (1.29, 1.85) | < 0.001 |
| Inflammatory bowel disease | 80 (5) | 98 (7) | 1.39 (1.03, 1.89) | 0.03 |
| Diverticular disease | 196 (12) | 186 (13) | 1.04 (0.84, 1.29) | 0.72 |
| Epidemiologic class | ||||
| Healthcare-associated | 857 (52) | 854 (58) | Reference | |
| Community-associated | 784 (48) | 626 (42) | 0.80 (0.68, 0.91) | 0.001 |
| Location of stool collection | ||||
| Hospital/LTACH† | 1329 (81) | 1300 (88) | Reference | |
| Ambulatory and other locations‡ | 312 (19) | 180 (12) | 0.56 (0.45, 0.68) | < 0.001 |
| Hospital admission§ | 1414 (86) | 1395 (94) | 2.73 (2.10, 3.55) | < 0.001 |
| Admitted from home | 1384 (84) | 1242 (84) | 0.96 (0.79, 1.16) | 0.64 |
| Medications in prior 12 weeks | ||||
| Antibiotics | 1263 (77) | 1185 (80) | 1.24 (1.04, 1.48) | 0.02 |
| Immunosuppressive therapy | 438 (27) | 481 (33) | 1.30 (1.11, 1.52) | 0.001 |
| Healthcare exposures in prior 12 weeksǁ | 1069 (65) | 1016 (69) | 1.19 (1.02, 1.38) | 0.03 |
*Excludes patients with unknown duration of treatment, unknown treatment status, or who did not receive treatment
†Includes samples collected in emergency room or observation unit on the same day as acute care admission
‡Other locations include long-term care facilities
§Admitted to hospital at time of or within 7 days after stool collection
ǁIncludes chronic hemodialysis, surgery, ER visit, hospital admission, residence in long-term care facility or skilled nursing facility, or observation unit admission in prior 12 weeks
LTACH long-term acute care hospital