Advanced Search

Study Preview



Study Title and Description

Underlying disease severity as a major risk factor for nosocomial Clostridium difficile diarrhea.



Key Questions Addressed
2 Key Question 2 - Description of studies evaluating risk factors for CDI
  • Comments Comments (
    0
    ) |
5 Key Question 5 - Summary of risk factors for CDI
  • Comments Comments (
    0
    ) |

Primary Publication Information
  • Comments Comments (
    0
    ) |
TitleData
Title Underlying disease severity as a major risk factor for nosocomial Clostridium difficile diarrhea.
Author Kyne L., Sougioultzis S., McFarland LV., Kelly CP.
Country Gerontology Division, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA.
Year 2002
Numbers Pubmed ID: 12452292

Secondary Publication Information
There are currently no secondary publications defined for this study.


Extraction Form: Key Question 1 - Description of studies evaluating risk factors for CDI (Table C3)
Design Details
Question... Follow Up Answer Follow-up Answer
Study Type Prospective cohort series
  • Comments Comments (
    0
    ) |
Objective Determine the diagnostic accuracy of an index of underlying disease severity (Horn’s index) in identifying patients with a high probability of having nosocomial CDI as a complication of antimicrobial therapy
  • Comments Comments (
    0
    ) |
Population 252 inpatients and receiving antibiotics. Mean age 74 years; female 60%; Disease severity (Horn’s index) 1 (mild) 30% (n=76) 2 (moderate) 37% (n=93) 3 (severe) 22% (n=55) 4 (extremely severe) 11% (n=28) 28 (11%) of the patients had CDI
  • Comments Comments (
    0
    ) |
Methods CDI defined as diarrhea (•3 unformed stools for •2 days) not attributed to any other cause that occurred in association with a positive stool test for C. difficile. Horn’s index as a measure of the severity of underlying disease at the time of admission to the hospital, rated as follows: mild=1; moderate =2 (more severe disease but uncomplicated recovery expected); severe (major illness or complications or multiple conditions requiring treatment) =3; extremely severe (catastrophic illness that may lead to death) =4. Analysis: stepwise multivariable logistic regression
  • Comments Comments (
    0
    ) |
Results Extremely severe underlying disease was associated with CDI (OR 17.6 95%CI: 5.8 to 53.5). Sensitivity, specificity, and positive and negative predictive values of a Horn’s index score of 3 or more (severe to extremely severe disease) as a predictor of nosocomial C. difficile diarrhea were 79%, 73%, 27%, and 96%, respectively.
  • Comments Comments (
    0
    ) |
Study Origin United States
  • Comments Comments (
    0
    ) |




Results & Comparisons

No Results found.

Extraction Form: Key Question 2 - Summary of risk factors for CDI (Table 7)
Arms
No arms have been defined in this extraction form.

Baseline Characteristics
Question Total Comments
AnswerFollow-up
Specific Antibiotic Use NS
  • Comments Comments (
    0
    ) |
General Antibiotic Use NS
  • Comments Comments (
    0
    ) |
Health Status or Disease Severity Severe underlying dz OR = 17.6
  • Comments Comments (
    0
    ) |
Acid Suppression NS
  • Comments Comments (
    0
    ) |
Hospitalization in an ICU NE
  • Comments Comments (
    0
    ) |
Age NS
  • Comments Comments (
    0
    ) |
Miscellaneous
  • Comments Comments (
    0
    ) |



Results & Comparisons

No Results found.