Table 3 Risk factors for CDAD relapse
Variable | Single episode | Recurrence of symptoms | Univariate analysis | Multivariate analysis | ||
|---|---|---|---|---|---|---|
(N = 168) | (N = 42) | p | OR (95% CI) | p | OR (95% CI) | |
Demographic characteristics | ||||||
Median age [years (IQR)] | 67.5 (57–76) | 74 (58–82) | 0.266 | 1.01 (0.99-1.03) | ||
Female gender [n (%)] | 86 (51.19) | 24 (57.14) | 0.489 | 1.27 (0.61-2.66) | ||
Urban area [n (%)] | 111 (66.07) | 35 (83.33) | 0.029 | 0.39 (0.14-0.97) | ||
Clinical and evolutive characteristics | ||||||
Nosocomial infection with CD [n (%)] | 164 (97.62) | 40 (95.24) | 0.344 | 2.05 (0.18-14.83) | ||
Median hospitalization for CDAD [days (IQR)] | 10 (7–13) | 12 (8–17) | 0.004 | 1.12 (1.05-1.19) | 0.0015 | 1.10 (1.03-1.16) |
Median no. of leukocytes [cells/μl (IQR)] | 9615 (6930–13820) | 12625 (7830–17230) | 0.277 | 1.00 (1.00-1.001) | ||
Leukocytosis ≥ 16000 cells/μl [n (%)] | 29 (17.26) | 15 (35.71) | 0.008 | 2.66 (1.18-5.99) | ||
Hypoalbuminemia <3.5 g/dl [n (%)] | 127 (75.59) | 39 (92.86) | 0.014 | 4.2 (1.22-22.22) | ||
Fever > 37.5°C [n (%)] | 40 (23.81) | 13 (30.95) | 0.340 | 1.43 (0.64-3.20) | ||
Median ATLAS Score (IQR) | 2 (2–4) | 4 (2–5) | 0.004 | 1.27 (1.07-1.51) | ||
Mild clinical form [n (%)] | 7 (4.17) | 0 (0) | 0.349 | 0.00 (0.00-2.78) | ||
Moderate clinical form [n (%)] | 127 (75.59) | 26 (61.90) | 0.074 | 0.52 (0.24-1.14) | ||
Severe clinical form [n (%)] | 34 (20.24) | 16 (38.09) | 0.015 | 2.43 (1.10-5.33) | ||
Comorbidities | ||||||
Median Charlson comorbidity index score (IQR) | 2.5 (1–4) | 2.5 (1–4) | 0.775 | 1.02 (0.88-1.18) | ||
Median Charlson comorbidity Index score adjusted for age (IQR) | 5 (3–7) | 5 (4–7) | 0.446 | 1.04 (0.93-1.16) | ||
Malignancy [n (%)] | 34 (20.24) | 10 (23.81) | 0.611 | 1.23 (0.51-2.93) | ||
Colorectal cancer [n (%)] | 5 (2.98) | 0 (0) | 0.585 | 0.00 (0.00-4.40) | ||
Diabetes mellitus [n (%)] | 39 (23.21) | 9 (21.43) | 0.805 | 0.90(0.37-2.189 | ||
Renal disease [n (%)] | 40 (23.81) | 7 (16.67) | 0.320 | 0.64 (0.24-1.65) | ||
Chronic renal failure [n (%)] | 29 (17.26) | 6 (14.29) | 0.643 | 0.8 (0.25-2.16) | ||
Chronic heart disease [n (%)] | 85 (50.59) | 26 (61.90) | 0.189 | 1.59 (0.75-3.36) | ||
Peripheral vascular disease [n (%)] | 30 (17.86) | 10 (23.81) | 0.379 | 1.44 (0.59-3.46) | ||
Dementia [n (%)] | 7 (4.17) | 3 (7.14) | 0.422 | 1.77 (0.28-8.17) | ||
Cerebrovascular disease [n (%)] | 42 (25) | 13 (30.95) | 0.432 | 1.34 (0.60-2.99) | ||
Chronic pulmonary pathology [n (%)] | 30 (17.86) | 8 (19.05) | 0.857 | 1.08 (0.41-2.75) | ||
Moderate/severe liver pathology [n (%)] | 19 (11.31) | 7 (16.67) | 0.345 | 1.57 (0.55-4.35) | ||
Gastrointestinal ulcer [n (%)] | 18 (10.71) | 5 (11.90) | 0.786 | 1.13 (0.31-3.42) | ||
Inflammatory bowel disease [n (%)] | 4 (2.38) | 1 (2.38) | 1 | 1 (0.02-10.46) | ||
Haematological pathology [n (%)] | 5 (2.98) | 1 (2.38) | 1 | 0.80 (0.02-7.40) | ||
Concomitant infections [n (%)] | 48 (28.57) | 12 (28.57) | 1 | 1 (0.44-2.24) | ||
Risk factors for CDAD in the past 2 months | ||||||
Chemotherapy [n (%)] | 12 (7.14) | 2 (4.76) | 0.740 | 0.65 (0.07-3.11) | ||
Radiotherapy [n (%)] | 5 (2.98) | 2 (4.76) | 0.629 | 1.63 (0.15-10.38) | ||
Corticotherapy [n (%)] | 14 (8.33) | 1 (2.38) | 0.313 | 0.27 (0.01-1.87) | ||
Dialysis [n (%)] | 6 (3.57) | 1 (2.38) | 1 | 0.66 (0.01-5.67) | ||
Surgery [n (%)] | 78 (46.43) | 19 (45.24) | 0.889 | 0.95 (0.46-1.98) | ||
Gastro-intestinal/abdominal surgery [n (%)] | 36 (21.43) | 7 (16.67) | 0.493 | 0.73 (0.27-1.91) | ||
Enteral feeding [n (%)] | 4 (2.38) | 0 (0) | 0.586 | 0.00 (0.00-6.12) | ||
Parenteral feeding [n (%)] | 19 (11.31) | 3 (7.14) | 0.578 | 0.60 (0.11-2.21) | ||
Prior antibiotic treatment [n (%)] | 120 (71.43) | 25 (59.52) | 0.135 | 1.70 (0.80-3.62) | ||
Intestinal motility inhibitors after CDAD onset | 15 (8.93) | 5 (11.90) | 0.560 | 1.38 (0.37-4.32) | ||
Proton pump inhibitors after CDAD onset [n (%)] | 21 (12.50) | 1 (2.38) | 0.086 | 0.17 (0.00-1.13) | ||
Other antacids after CDAD onset [n (%)] | 54 (32.14) | 11 (26.19) | 0.455 | 0.75 (0.33-1.69) | ||
Antibiotics after CDAD diagnosis (other than the treatment for CDAD) [n (%)] | 23 (13.69) | 9 (21.43) | 0.212 | 1.72 (0.67-4.36) | ||
Median no. days of antibiotherapy after onset of episode (other than the treatment for CDAD) | 0 (0–0) | 0 (0–0) | 0.834 | 1.00 (0.92-1.10) | ||
Median no. antibiotics after onset of episode (other than the treatment for CDAD) [no. (IQR)] | 0 (0–0) | 0 (0–0) | 0.746 | 1.06 (0.73-1.55) | ||
Treatment for CDAD | ||||||
Metronidazole [n (%)] | 37 (22.02) | 5 (11.9) | 0.142 | 0.48 (0.14-1.35) | ||
Vancomycin [n (%)] | 47 (27.98) | 11 (26.19) | 0.816 | 0.91 (0.39-2.08) | ||
Vancomycin + Metronidazole [n (%)] | 75 (44.64) | 24 (57.14) | 0.146 | 1.65 (0.79-3.46) | ||
Rifaximin - α (alone or in combination) [n (%)] | 7 (4.17) | 2 (4.76) | 1 | 1.15 (0.11-6.35) | ||