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01.08.2016 | original article | Ausgabe 15-16/2016

Wiener klinische Wochenschrift 15-16/2016

Can we improve the therapy of Clostridium difficile infection in elderly patients?

Zeitschrift:
Wiener klinische Wochenschrift > Ausgabe 15-16/2016
Autoren:
MD, PhD Katarina Bielakova, MD Emmanuela Fernandova, MD, PhD Prof. Hana Matejovska-Kubesova, MD, PhD Prof. Pavel Weber, MD Dana Prudius, Ing, PhD Josef Bednar

Summary

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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