P-006: Functional decline in older hospitalized patients with Clostridium difficile infection: prospective from French survey CLOdi

摘要

Background: Elderly are more often, severely and recurrently affected by Clostridium difficile infection (CDI). Poor functional status has been identified as a risk factor of severe CDI butfunctional outcomes after CDI haven't been studied. Methods: This was a French multicentric observational prospective study including patients aged ≥ 75 years hospitalized with confirmed diagnosis of CDI. Main criteria was functional status, measured by the Activities of Daily Living (ADL) score and was assessed at baseline, admission, discharged and 3 months after discharged. Results: 126 patients had a functional status gathered at baseline and 3 months after discharged. Mean age was 86.3 ± 5.3 years. 53% had functional decline 3 months between baseline and 3 months after discharge. 49% had a functional decline between baseline and admission. During hospitalization, 16% had a functional decline. 42% didn't regain their prior functional status at discharge. Functional decline between baseline and admission (p < 0.001) and, between admission and discharge (p < 0.001) were highly associated with functional decline between baseline and 3 months after discharged independently from severity of CDI, CDI recurrence, comorbidities, nutritional status, baseline functional status. None other factors were significantly associated with functional decline but higher baseline ADL show a tendency to be associated to. Key messages: This prospective study shows that CDI leads to functional decline in elderly whatever infection severity or patient's characteristics. Particular attention must be paid to prehospital functional decline at admission and an early multidimensional and physical care is needed especially if patients are slightly dependent at baseline.