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Table 2 Risk factors for unfavourable outcome of CDAD

From: Clostridium difficile in western Romania: unfavourable outcome predictors in a hospital for infectious diseases

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)