Older age , use of antibiotics after diagnosis , use of proton pump inhibitors , and strain type were the most frequent risk factors for recurrence .
Older age , leucocytosis , renal failure and co-morbidities were frequent risk factors for complicated CDI .
When considered alone , mortality was associated with age , co-morbidities , hypo-albuminemia , leucocytosis , acute renal failure , and infection with ribotype 027 .
BACKGROUND Clostridium difficile infection ( CDI ) can lead to complications , recurrence , and death .
Numerous studies have assessed risk factors for these unfavourable outcomes , but systematic review s or meta-analyses published so far were limited in scope or in quality .
Reducing the risk of severe complications among patients with Clostridium difficile infection.
BACKGROUND The incidence and severity of Clostridium difficile infections are increasing , and there is a need to optimize the prevention of complicated disease . OBJECTIVE To identify modifiable processes of care associated with an altered risk of C difficile complications . METHODS A retrospective cohort study ( with prospect i ve case ascertainment ) of all C difficile infections during 2007⁄2008 at a tertiary care hospital was conducted . RESULTS Severe complications were frequent ( occurring in 97 of 365 [ 27 % ] C difficile episodes ) , with rapid onset ( median three days postdiagnosis ) . On multivariable analysis , nonmodifiable predictors of complications included repeat infection ( OR 2.67 ) , confusion ( OR 2.01 ) , hypotension ( OR 0.97 per increased mmHg ) and elevated white blood cell count ( OR 1.04 per 109 cells⁄L ) . Protection from complications was associated with initial use of vancomycin ( OR 0.24 ) ; harm was associated with ongoing use of exacerbating antibiotics ( OR 3.02 ) . CONCLUSION C difficile infections often occur early in the disease course and are associated with high complication rates . Clinical factors that predicted a higher risk of complications included confusion , hypotension and leukocytosis . The most effective ways to improve outcomes for patients with C difficile colitis are consideration of vancomycin as first-line treatment for moderate to severe cases , and the avoidance of unnecessary antibiotics
Older age , use of antibiotics after diagnosis , use of proton pump inhibitors , and strain type were the most frequent risk factors for recurrence .
Older age , leucocytosis , renal failure and co-morbidities were frequent risk factors for complicated CDI .
When considered alone , mortality was associated with age , co-morbidities , hypo-albuminemia , leucocytosis , acute renal failure , and infection with ribotype 027 .
BACKGROUND Clostridium difficile infection ( CDI ) can lead to complications , recurrence , and death .
Numerous studies have assessed risk factors for these unfavourable outcomes , but systematic review s or meta-analyses published so far were limited in scope or in quality .