Hardt C, Berns T, Treder W, Dumoulin FL. Univariate and multivariate analysis of risk factors for severe clostridium difficile-associated diarrhoea: Importance of co-morbidity and serum C-reactive protein. World J Gastroenterol 2008; 14(27): 4338-4341 [PMID: 18666322 DOI: 10.3748/wjg.14.4338]
Corresponding Author of This Article
Franz Ludwig Dumoulin, Professor, MD, Department of Medicine Gemeinschaftskrankenhaus Bonn, Bonner Talweg 4-6, Bonn D-53113, Germany. f.dumoulin@gk-bonn.de
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Rapid Communication
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World J Gastroenterol. Jul 21, 2008; 14(27): 4338-4341 Published online Jul 21, 2008. doi: 10.3748/wjg.14.4338
Univariate and multivariate analysis of risk factors for severe clostridium difficile-associated diarrhoea: Importance of co-morbidity and serum C-reactive protein
Christian Hardt, Thomas Berns, Wolfgang Treder, Franz Ludwig Dumoulin
Christian Hardt, Franz Ludwig Dumoulin, Department of Medicine, Gemeinschaftskrankenhaus Bonn, Bonner Talweg 4-6, Bonn D-53113, Germany
Thomas Berns, Department of Surgery, St.-Agnes-Hospital Bocholt, Barloer Weg 125, Bocholt D-46399, Germany
Wolfgang Treder, Münster Center for Laboratory Diagnostics, Hafenweg 11, Münster D-48155, Germany
Author contributions: Berns T, Hardt C and Dumoulin FL designed the study; Treder W provided relevant microbiology data; Hardt C performed data acquisition; Dumoulin FL and Hardt C analyzed the data and wrote the paper.
Correspondence to: Franz Ludwig Dumoulin, Professor, MD, Department of Medicine Gemeinschaftskrankenhaus Bonn, Bonner Talweg 4-6, Bonn D-53113, Germany. f.dumoulin@gk-bonn.de
Telephone: +49-228-5081561
Fax: +49-228-5081562
Received: May 6, 2008 Revised: June 16, 2008 Accepted: June 23, 2008 Published online: July 21, 2008
Abstract
AIM: To investigate risk factors for severe clostridium difficile associated diarrhoea (CDAD) in hospitalized patients.
METHODS: We analysed risk factors for severe CDAD (associated with systemic signs of hypovolemia) in 124 hospitalized patients by retrospective chart review.
RESULTS: Severe CDAD was present in 27 patients (22%). Statistical analysis showed a significant association with a higher 30-d mortality (33% vs 4%, P < 0.001) and a higher proportion of longer hospital stay exceeding 14 d (74% vs 52%, P = 0.048). Charlson co-morbidity score (OR 1.29 for 1 point increment, P < 0.05) and serum C-reactive protein at diagnosis (OR 1.15 for 10 mg/L increment, P < 0.001) were independent predictors of severe CDAD.
CONCLUSION: Patients with a severe level of co-morbidity and high serum C-reactive protein levels at the time of diagnosis should receive particular attention.
