Gut Liver.  2014 Jan;8(1):41-48.

The Simple Predictors of Pseudomembranous Colitis in Patients with Hospital-Acquired Diarrhea: A Prospective Observational Study

• Yang BK
• Do BJ
• Kim EJ
• Lee JU
• Kim MH
• Kang JG
• Kim HS
• Kim KH
• Jang MK
• Lee JH
• Kim HY
• Shin WG

Abstract

BACKGROUND/AIMS
As the incidence rate of and mortality from pseudomembranous colitis (PMC) are increasing worldwide, it is important to study the simple predictive risk factors for PMC among patients with hospital-acquired diarrhea (HAD). This study focused on identifying the clinical risk factors that can easily predict PMC.
METHODS
The presumed HAD patients were prospectively recruited at the Hallym University Kangdong Sacred Heart Hospital.
RESULTS
Age of 70 and older (adjusted odds ratio [OR], 1.76; 95% confidence interval [CI], 1.12 to 0.75), use of proton pump inhibitors (adjusted OR, 4.07; 95% CI, 2.512 to 6.57), use of cephalosporins (adjusted OR, 2.99; 95% CI, 1.82 to 4.94), and underlying cancer (adjusted OR, 1.72; 95% CI, 1.04 to 2.82) were independent risk factors for PMC in the multivariate logistic regression analysis. The prevalence of PMC was very low in the patients with HAD who exhibited no risk factors.
CONCLUSIONS
The risk factors for PMC in patients with HAD included cephalosporin use, proton pump inhibitor use, old age, and cancer. Considering the strongly negative predictive values of these risk factors, endoscopic evaluation can be delayed in patients with HAD without risk of developing PMC.

Keyword

Enterocolitis, pseudomembranous; Clostridium difficile; Risk factors; Predictors

MeSH Terms

Adult
Aged
Aged, 80 and over
*Clostridium difficile
Cross Infection/complications/*epidemiology
Diarrhea/complications/*epidemiology
Enterocolitis, Pseudomembranous/complications/*epidemiology
Female
Humans
Male
Middle Aged
Prevalence
Prospective Studies
Republic of Korea/epidemiology
Risk Factors