Clinical Risk Factors for Severe Clostridium difficile–associated Disease

摘要

Identifying patients who are at high risk for severe Clostridium diffi cile–associated disease (CDAD) early in the course of their infection may help clinicians improve outcomes. Therefore, we compared clinical features asso-ciated with severe versus nonsevere CDAD by retrospec-tively reviewing records of hospitalized patients whose fecal assays were positive for C. diffi cile toxin. Of 336 patients, 12.2% had severe disease and 10.1% died from all causes. Regression modeling showed the following to be signifi cant-ly associated with severe CDAD (p70 years (odds ratio [OR] 3.35), maximum leukocyte count >20,000 cells/mL (OR 2.77), minimum albumin level 2 mg/dL (OR 2.47), small bowel obstruction or ileus (OR 3.06), and computed tomog-raphy scan showing colorectal in. ammation (OR 13.54). These clinical and laboratory markers for severe disease may be useful for identifying patients at risk for serious out-comes or death