Sie können Bookmarks mittels Listen verwalten, loggen Sie sich dafür bitte in Ihr SLUB Benutzerkonto ein.
Medientyp:
E-Artikel
Titel:
Development and validation of a simple and robust model to predict 30-day mortality in patients with Clostridioides difficile-associated enterocolitis
Beteiligte:
Katzer, Katrin Claudia;
Hagel, Stefan;
Reuken, Philipp Alexander;
Bruns, Tony;
Stallmach, Andreas
Erschienen:
BMJ, 2020
Erschienen in:BMJ Open Gastroenterology
Sprache:
Englisch
DOI:
10.1136/bmjgast-2020-000468
ISSN:
2054-4774
Entstehung:
Anmerkungen:
Beschreibung:
<jats:sec><jats:title>Objective</jats:title><jats:p><jats:italic>Clostridioides difficile</jats:italic> infection (CDI) is a common healthcare-associated infection and associated with high morbidity and mortality. As current guidelines recommend treatment stratified for disease severity, this study aimed to identify predictors of 30-day mortality in order to develop a robust prediction model.</jats:p></jats:sec><jats:sec><jats:title>Design</jats:title><jats:p>This was a retrospective analysis of 207 inpatients with CDI who were treated at the Jena University Hospital between September 2011 and December 2015. In a training cohort (n=127), predictors of 30-day mortality were identified by receiver operating characteristics analysis and logistic regression. The derived model was validated in an independent cohort of 80 inpatients with CDI.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>Within 30 days, 35 (28%) patients in the training cohort died from any cause. C-reactive protein (CRP) of ≥121 mg/L (OR 3.80; 95% CI 1.64 to 7.80; p=0.003) and lower systolic blood pressure of ≤104 mm Hg (OR 3.73; 95% CI 1.63 to 8.53; p=0.002) at diagnosis as well as development of renal impairment (serum creatinine >1.5×baseline; OR 5.61; 95% CI 1.94 to 16.26; p=0.035) within the first 6 days were associated with 30-day mortality in univariate analysis. The use of these parameters enabled correct mortality prediction in 73% of cases on the day of diagnosis and in 76% at day 6. In the validation cohort, 30-day mortality was 18/80 (23%). Our model enabled a 73.7% correct prediction concerning 30-day mortality on day 6 after diagnosis of CDI.</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>Hypotension and CRP elevation on the day of diagnosis as well as occurrence of kidney dysfunction during the first 6 days are suitable parameters to predict 30-day mortality in patients with CDI who need to be treated in the hospital.</jats:p></jats:sec>