Univariate and multivariate analysis of risk factors for severe clostridium difficile-associated diarrhoea: Importance of co-morbidity and serum C-reactive protein

Table 1 Patient characteristics

Patient characteristics	Data
Age1 (yr)	76 (18-93)
Sex
Female	71 (57%)
Male	53 (43%)
Nursing home residency	19 (15%)
Charlson’s comorbidity score	4 (0-10)
GI procedures including PEG and surgery	13 (10%)
Previous medication:
Antibiotic therapy within 6 wk prior to onset CDAD	101 (81%)
Acid-suppressive therapy	66 (53%)
Immunosuppressive therapy	25 (20%)
Opioid use	57 (46%)
Laxative use	30 (24%)
Clinical features of CDAD
Hospital-acquired CDAD	101 (81%)
Interval onset of diarrhoea to CDAD therapy ≥ 7 d	45 (37%)
Body temperature ≥ 38°C	56 (45%)
Severe CDAD	27 (22%)
Laboratory at diagnosis:
White blood cell count (G/L)	14.1 (4.6-81.3)
CRP (mg/L)	118 (2-413)
Creatinine (mg/L)	11.5 (3.1-110.5)
Sodium (mmol/L)	136 (114-145)
Potassium (mmol/L)	3.52 (2.43-5.07)
Continuation of initial antibiotic therapy despite CDAD	71 (57%)
Antibiotic therapy for CDAD	113 (91%)
Length of hospital stay > 14 d	70 (56%)
30-d mortality	13 (10%)

¹Data are given as median (range) or number (percentage).

Table 2 Univariate analysis of risk factors for severe CDAD

Variable	Non-severe CDAD (n = 97)	Severe CDAD (n = 27)	P
Male sex	41/42	12/44
Nursing home residency	12/12	7/26
Hospital-acquired CDAD	76/78	25/93
Immunosuppressive therapy	15/15	10/37	< 0.05
Previous antibiotic therapy	78/80	23/85
Acid-suppressive therapy	47/48	19/70
Therapy with opioids	40/41	17/63
Laxative use	19/20	11/41	< 0.05
GI procedures including PEG and surgery	13/13	0/0
Continuation of initial antibiotic therapy	52/54	19/70
Antibiotic treatment for CDAD	88/91	25/93
Body temperature ≥ 38°C	38/39	18/67	< 0.05
Therapy ≥ 7 d after onset diarrhoea	33/34	12/44
Length of hospital stay > 14 d	50/52	20/74	< 0.05
30-d mortality	4/4	9/33	< 0.001
Age (yr)	74 ± 12	77 ± 12
Charlson’s score (points)	3.4 ± 2.2	5 ± 2.6	< 0.001
White blood cell count (G/L)	15.3 ± 9.9	21.6 ± 10.4	< 0.01
C-reactive protein (mg/L)	109 ± 79	223 ± 92	< 0.001
Creatinine (mg/L)	14 ± 13	24 ± 17	< 0.01
Sodium (mmol/L)	135 ± 5	133 ± 7
Potassium (mmol/L)	3.6 ± 0.5	3.4 ± 0.5

Table 3 Multivariate analysis of possible risk factors for severe CDAD

	P	OR; 95% CI
Variable (unit)
Charlson’s score (points; 1-point increments)	< 0.05	1.39; 1.06-1.83
Body temperature ≥ 38°C		1.15; 0.35-3.83
Immunosuppressive therapy		1.84; 0.45-7.49
Acid-suppressive therapy		1.28; 0.39-4.21
Opioid use		2.50; 0.80-7.84
Laxative use		2.66; 0.79-8.97
C-reactive protein (mg/L; 10 mg/L increments)	< 0.01	11.2; 10.3-12.1
White blood cell count (G/L; 1 G/L increments)		1.01; 0.96-1.06
Creatinine level (mg/L; 10 mg/L increments)		12.5; 9.2-16.8
Reduced Model
Charlson’s score (points; 1-point increments)	< 0.05	1.29; 1.02-1.61
C-reactive protein (mg/L; 10 mg/L increments)	< 0.001	1.15; 1.08-1.22