Korean J Gastroenterol.  2016 Feb;67(2):81-86. 10.4166/kjg.2016.67.2.81.

Clinical Outcomes in Hospitalized Patients with Clostridium difficile Infection by Age Group

• Lee HC
• Kim KO
• Jeong YH
• Lee SH
• Jang BI
• Kim TN

• KMID: 2383545
• DOI: http://doi.org/10.4166/kjg.2016.67.2.81

Abstract

BACKGROUND/AIMS
Advanced age is a known risk factor of poor outcomes for colitis, including Clostridium difficile infection (CDI). The present study compares the clinical outcomes of young and old patients hospitalized for CDI.
METHODS
The clinical records of patients admitted from January 2007 to December 2013 with a diagnosis of CDI were analyzed. Patient baseline characteristics, clinical courses, and outcomes were compared with respect to age using a cut-off 65 years.
RESULTS
Of the 241,391 inpatients registered during the study period, 225 (0.1%) with a diagnosis of CDI were included in the study. The mean patient age was 67.7 years. Seventy-two patients (32.0%) were younger than 65 years and 153 patients (68.0%) were 65 years old or more. The male to female ratio in the younger group was 0.8, and 0.58 in the older group. All 225 study subjects had watery diarrhea; six patients (8.3%) complained of bloody diarrhea in the young group and 21 patients (13.7%) in the old group (p=0.246). Right colon involvement was more common in the old group (23.5% vs. 42.7%, p=0.033). Furthermore, leukocytosis (41.7% vs. 67.3%, p=0.000), a CDI score of > or =3 points (77.8% vs. 89.5%, p=0.018), and hypoalbuminemia (58.3% vs. 76.5%, p=0.005) were more common in the old group. Failure to first line treatment was more common in the old group (17 [23.6%] vs. 58 [37.9%], p=0.034).
CONCLUSIONS
Severe colitis and failure to first line treatment were significantly more common in patients age 65 years or more. More aggressive initial treatment should be considered for older CDI patients.

Keyword

Clostridium difficile infection; Elderly; Severity; Treatment

MeSH Terms

Adult
Age Factors
Aged
Aged, 80 and over
Albuminuria/etiology
Anti-Bacterial Agents/therapeutic use
Clostridium Infections/complications/*diagnosis/drug therapy
Diarrhea/complications
Female
Hospitalization
Humans
Leukocytosis/etiology
Male
Middle Aged
Retrospective Studies
Risk Factors
Severity of Illness Index
Anti-Bacterial Agents

Reference

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