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

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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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Acknowledgements

The study was supported by project SV MUNI/A/0945/2013 and binary logistic model outputs of this project LO1202 were created with financial support from the Ministry of Education, Youth and Sports under the “National Sustainability Programme I.”

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Authors and Affiliations

  1. Department of Internal Medicine, Geriatrics and General Practice, Faculty of Medicine, Masaryk University, Faculty Hospital Brno, Jihlavska 20, 62500, Brno, Czech Republic

    Katarina Bielakova MD, PhD, Emmanuela Fernandova MD,  Hana Matejovska-Kubesova MD, PhD,  Pavel Weber MD, PhD & Dana Prudius MD

  2. Department of Statistics and Optimization, Faculty of Mechanical Engineering, Brno University of Technology, Brno, Czech Republic

    Josef Bednar Ing, PhD

Authors
  1. Katarina Bielakova MD, PhD
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  2. Emmanuela Fernandova MD
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  3. Hana Matejovska-Kubesova MD, PhD
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  4. Pavel Weber MD, PhD
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  5. Dana Prudius MD
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  6. Josef Bednar Ing, PhD
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Corresponding author

Correspondence to Katarina Bielakova MD, PhD.

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Conflict of interest

K. Bielakova, E. Fernandova, H. Matejovska-Kubesova, P. Weber, D. Prudius and J. Bednar, declare that they have no competing interests.

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Bielakova, K., Fernandova, E., Matejovska-Kubesova, H. et al. Can we improve the therapy of Clostridium difficile infection in elderly patients?. Wien Klin Wochenschr 128, 592–598 (2016). https://doi.org/10.1007/s00508-016-1056-z

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  • DOI: https://doi.org/10.1007/s00508-016-1056-z

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