Can we improve the therapy of Clostridium difficile infection in elderly patients?
Language English Country Austria Media print-electronic
Document type Journal Article
PubMed
27501856
DOI
10.1007/s00508-016-1056-z
PII: 10.1007/s00508-016-1056-z
Knihovny.cz E-resources
- Keywords
- Antibiotic therapy, Binary logistic regression model, Clostridium difficile, Geriatric patient, Pseudomebranous colitis,
- MeSH
- Anti-Bacterial Agents therapeutic use MeSH
- Clostridioides difficile * MeSH
- Geriatric Assessment statistics & numerical data MeSH
- Incidence MeSH
- Humans MeSH
- Survival Rate MeSH
- Prognosis MeSH
- Enterocolitis, Pseudomembranous microbiology mortality therapy MeSH
- Risk Factors MeSH
- Sex Distribution MeSH
- Aged, 80 and over MeSH
- Aged MeSH
- Age Distribution MeSH
- Quality Improvement MeSH
- Check Tag
- Humans MeSH
- Male MeSH
- Aged, 80 and over MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Geographicals
- Czech Republic epidemiology MeSH
- Names of Substances
- Anti-Bacterial Agents MeSH
BACKGROUND: Clostridium difficile infection (CDI) is becoming a serious problem predominantly in geriatric patients, who are a significant risk group. The goal of this study was to evaluate the risk factors for mortality in CDI patients and to construct a binary logistic regression model that describes the probability of mortality in geriatric patients suffering from CDI. METHODS: In this retrospective study, we evaluated a group of 235 patients over 65 years of age with confirmed diagnoses of CDI, hospitalized at the Department of Internal Medicine, Geriatrics and General Practice, Brno, from January 2008 to December 2013. The examined group comprised 148 women (63 %) and 87 men (37 %). For the diagnosis of CDI, confirmation of A and B toxins in the patients' stool or an autopsy confirmation was crucial. RESULTS: The impact of antibiotic therapy on the increased incidence of CDI was clearly confirmed in our study group when examining patients' histories. Other risk factors included cerebrovascular disease, dementia, the presence of pressure ulcers, and immobility. Our new model consisted of a combination of the following parameters: the number of antibiotics used (from patients' history), nutritional status (Mini Nutritional Assessment short-form test), presence of pressure ulcers, and occurrence of fever. CONCLUSION: Our logistic regression model may predict mortality in geriatric patients suffering from CDI. This could help improve the therapeutic process.
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