Association of Clostridium difficile infection in hospital mortality: A systematic review and meta-analysis

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• 作者：Tianyi Gao ; MD^a ; ¹ ; Bangshun He ; MD^b ; ¹ ; Yuqin Pan ; MD^b ; Qiwen Deng ; MD^b ; Huiling Sun ; MD^b ; Xian Liu ; MD^b ; Jie Chen ; MD^b ; Shukui Wang ; PhD^a ; ^{sk_wang@njmu.edu.cn" class="auth_mail" title="E-mail the corresponding author} ; Yongxiang Xia ; PhD^a
• 关键词：Clostridium difficile infection ; Hospital mortality ; Intensive care unit ; Surgical wards ; Charlson comorbidity index
• 刊名：American Journal of Infection Control
• 出版年：2015
• 出版时间：1 December 2015
• 年：2015
• 卷：43
• 期：12
• 页码：1316-1320
• 全文大小：601 K

文摘

The purpose of this study was to evaluate whether Clostridium difficile infection (CDI) contributed to hospital mortality and whether the correlation between intensive care units (ICUs) and surgical wards in hospital CDI risk still remain controversial.

Methods

By meta-analysis, 12 eligible studies involving 8,509 cases and 247,285 controls were identified via PubMed and Embase.

Results

CDI patients had a higher risk of hospital mortality than non-CDI patients (odds ratio [OR], 1.899; 95% confidence interval [CI], 1.269-2.840), especially in 30-day mortality (OR, 2.521; 95% CI, 1.800-3.531). No correlation was found between hospital CDI and Charlson comorbidity index (OR, 0.830; 95% CI, 0.559-1.231). Patients treated in the ICU have an increased risk of hospital CDI (OR, 1.820; 95% CI, 1.161-2.851). However, the risk of CDI in patients who used to have surgery in surgical wards was not different to patients in the other departments (OR, 1.054; 95% CI, 0.838-1.325). Moreover, CDI patients in studies from the most recent 5 years have a higher risk of hospital mortality (OR, 2.171; 95% CI, 1.426-3.304).

Conclusion

Hospital CDI was associated with an increased risk of hospital mortality, especially in 30-day mortality. In addition, when compared with past years, CDI patients have a higher risk of hospital mortality in the most recent 5 years. Given the rapid dissemination of this organism worldwide, there is a need to aggressively develop and evaluate primary preventive strategies targeting CDI among hospitalized patients, especially in ICUs.