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Updated: Jun 21, 2026
09:12
A Protein Microarray Assay for Serological Determination of Antigen-specific Antibody Responses Following Clostridium difficile Infection
Published on: June 15, 2018
Clostridium difficile-associated disease and mortality among the elderly critically ill
Marya D Zilberberg1, Andrew F Shorr, Scott T Micek
1School of Public Health and Health Sciences (MDZ), University of Massachusetts, Amherst, MA, USA. Marya@evimedgroup.org
Critical Care Medicine
|July 23, 2009
Summary
Elderly intensive care unit patients with Clostridium difficile-associated disease face higher mortality. A new RASA score aids in predicting 30-day survival for this growing population.
Area of Science:
- Critical Care Medicine
- Infectious Diseases
- Geriatrics
Background:
- Clostridium difficile-associated disease (CDAD) is a growing public health concern, particularly with increasing hospitalizations and hypervirulent strains.
- Advanced age is a significant risk factor for both developing CDAD and mortality from the infection.
- Elderly patients in intensive care units (ICUs) with CDAD have high mortality, but risk factors and outcomes are not well understood.
Purpose of the Study:
- To describe the epidemiology of CDAD in critically ill elderly patients (aged 65 years and older).
- To develop a simple clinical decision rule for predicting 30-day mortality in this patient group.
Main Methods:
- Secondary analysis of a retrospective cohort study.
- Involved 278 critically ill patients with CDAD, with 148 patients aged 65 years and older.
- Developed a multivariable logistic regression model to predict 30-day mortality, creating the RASA score.
Main Results:
- Elderly patients (≥65 years) had a 68% higher likelihood of 30-day mortality compared to younger patients.
- The RASA score (Risk of chronic respiratory disease, Age 75+, Septic shock, APACHE II score 20+) demonstrated a receiver operating characteristics of 0.740.
- The RASA score effectively predicted 30-day mortality in critically ill elderly patients with CDAD.
Conclusions:
- Elderly patients constitute about 50% of ICU patients with CDAD and experience higher 30-day mortality.
- A simple bedside prediction rule, like the RASA score, can assist in optimizing treatment decisions for this vulnerable population.
- The RASA score offers a practical tool for risk stratification and management of elderly ICU patients with CDAD.
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