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Post-Discharge Outcomes of Elderly Patients Hospitalized for Inflammatory Bowel Disease Flare Complicated by Clostridioides difficile Infection
I. Goren, O. Fallek Boldes, T. Boldes, O. Knyazev, A. Kagramanova, JK. Limdi, E. Liu, K. Sethi-Arora, T. Holvoet, P. Eder, C. Bezzio, S. Saibeni, M. Vernero, E. Alimenti, M. Chaparro, JP. Gisbert, E. Orfanoudaki, IE. Koutroubakis, D. Pugliese, G....
Jazyk angličtina Země Anglie, Velká Británie
Typ dokumentu časopisecké články, multicentrická studie
PubMed
39435855
DOI
10.1093/ecco-jcc/jjae161
Knihovny.cz E-zdroje
- MeSH
- Clostridioides difficile MeSH
- hospitalizace statistika a číselné údaje MeSH
- idiopatické střevní záněty * komplikace MeSH
- klostridiové infekce * komplikace epidemiologie MeSH
- lidé středního věku MeSH
- lidé MeSH
- propuštění pacienta MeSH
- retrospektivní studie MeSH
- rizikové faktory MeSH
- senioři MeSH
- syndrom vzplanutí nemoci MeSH
- znovupřijetí pacienta statistika a číselné údaje MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- multicentrická studie MeSH
OBJECTIVES: Elderly hospitalized patients with inflammatory bowel disease (IBD) flare and concurrent Clostridioides difficile infection (CDI) are considered at high risk of IBD-related complications. We aimed to evaluate the short-,intermediate-, and long-term post-discharge complications among these patients. METHODS: A retrospective multicenter cohort study assessing outcomes of elderly individuals (≥60 years) hospitalized for an IBD flare who were tested for CDI (either positive or negative) and discharged. The primary outcome was the 3-month post-discharge IBD-related complication rates defined as steroid dependency, re-admissions (emergency department or hospitalization), IBD-related surgery, or mortality. We assessed post-discharge IBD-related complications within 6 month and mortality at 12 month among secondary outcomes. Risk factors for complication were assessed by multivariable logistic regression. RESULTS: In a cohort of 654 patients hospitalized for IBD {age 68.9 (interquartile range [IQR]): 63.9-75.2 years, 60.9% ulcerative colitis (UC)}, 23.4% were CDI-positive. Post-discharge complication rates at 3 and 6 months, and 12 months mortality, did not differ significantly between CDI-positive and CDI-negative patients (32% vs 33.1%, p = 0.8; 40.5% vs 42.5%, p = 0.66; and 4.6% vs 8%, p = 0.153, respectively). The Charlson comorbidity index was the only significant risk factor for complications within 3 months (aOR 1.1), whereas mesalamine (5-aminosalicylic acid [5-ASA]) use was protective (aOR 0.6). An UC diagnosis was the sole risk factor for complication at 6 months (aOR 1.5). Clostridioides difficile infection did not significantly impact outcomes or interact with IBD type. CONCLUSIONS: In elderly IBD patients hospitalized for IBD flare and subsequently discharged, a concurrent CDI infection was not associated with post-discharge IBD-related complications or mortality up to 1 year.
Department of Biomedical Sciences Humanitas University Pieve Emanuele Milan Italy
Department of Clinical Medicine and Surgery Federico Jj University Gastroenterology Naples Italy
Department of Gastroenterology ASST Rhodense Rho Italy
Department of Gastroenterology Evangelismos Polycliniki General Hospital Athens Greece
Department of Gastroenterology University Hospital Ghent Ghent Belgium
Department of Gastroenterology University Hospital of Heraklion Heraklion Greece
Department of Gastroenterology Venizeleio General Hospital Heraklion Greece
Department of Gastroenterology VITAZ St Niklaas Belgium
Department of Internal Medicine and Pediatrics Ghent University Ghent Belgium
Department of Medical Sciences University of Pavia Gastroenterology Unit Pavia Italy
Department of Medical Sciences University of Turin Turin Italy
Department of Public Health University of Naples Federico Jj Gastroenterolog Naples Italy
Dept de Gastroenterologie South Lyon University Hospital Hospices Civils de Lyon Lyon France
Division of Gastroenterology Mater Dei Hospital Birkirkara Malta
Division of Gastroenterology Northern Care Alliance Hospitals NHS Foundation Trust Manchester UK
Division of Gastroenterology SUNY Upstate Medical University Syracuse NY USA
Faculty of Biology Medicine and Health University of Manchester Manchester UK
IBD Center IRCCS Humanitas Research Hospital Rozzano Milan Italy
IBD Unit San Filippo Neri Hospital Rome Italy
Moscow Clinical Scientific Center named after A S Loginov Moscow Russia
National Medical Research Center of Coloproctology named after A N Ryzhykh Moscow Russia
Research Institute of Health Organization and Medical Management Moscow Russia
Citace poskytuje Crossref.org
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