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Published on: December 10, 2016
Clinical Outcomes in Hospitalized Patients with Clostridium difficile Infection by Age Group
Ho Chan Lee1, Kyeong Ok Kim1, Yo Han Jeong1
1Division of Gastroenterology and Hepatology, Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea.
Insights
Older patients (≥65 years) hospitalized with Clostridium difficile infection (CDI) experienced more severe colitis and treatment failures. Aggressive initial treatment is recommended for elderly CDI patients.
Area of Science:
- Infectious Diseases
- Gastroenterology
- Geriatric Medicine
Background:
- Advanced age is a significant risk factor for adverse outcomes in colitis, including Clostridium difficile infection (CDI).
- Understanding age-related differences in CDI clinical presentation and outcomes is crucial for effective management.
- This study investigates the impact of age on the clinical course and treatment response in hospitalized CDI patients.
Purpose of the Study:
- To compare the clinical outcomes of young and elderly patients hospitalized with Clostridium difficile infection (CDI).
- To identify age-specific risk factors and treatment challenges in CDI patients.
- To inform clinical decision-making regarding the management of CDI in different age groups.
Main Methods:
- Retrospective analysis of clinical records for patients diagnosed with CDI between January 2007 and December 2013.
- Comparison of patient demographics, clinical characteristics, and outcomes between two age groups: <65 years and ≥65 years.
- Statistical analysis to determine significant differences between the young and old patient cohorts.
Main Results:
- Elderly patients (≥65 years) showed a higher incidence of right colon involvement (42.7% vs. 23.5%) and leukocytosis (67.3% vs. 41.7%).
- A higher proportion of older patients presented with severe disease markers, including a CDI score of ≥3 points (89.5% vs. 77.8%) and hypoalbuminemia (76.5% vs. 58.3%).
- Failure to achieve initial treatment success was significantly more common in the elderly group (37.9% vs. 23.6%).
Conclusions:
- Patients aged 65 years and older with CDI face a higher risk of severe colitis and treatment failure.
- The findings suggest a need for more aggressive initial treatment strategies in older adults diagnosed with CDI.
- Age-specific considerations are essential for optimizing therapeutic approaches and improving outcomes in Clostridium difficile infection.
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 ≥ 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.
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