The following is a summary of “Mortality in clostridioides difficile infection among patients hospitalized at the university clinical hospital in Wroclaw, Poland – a 3-year observational study,” published in the June 2024 issue of Infectious Disease by Drobnik et al.

The rising prevalence of Clostridioides difficile infection (CDI) necessitates improved methods to predict disease severity and mortality risk.

Researchers conducted a retrospective study investigating the factors influencing both occurrence and death rates among patients hospitalized with CDI.

They conducted statistical analysis on data extracted from patients’ medical records. Inclusion criteria required confirmation of CDI through laboratory testing and the presence of relevant symptoms. For the mortality analysis, only adult patients who died during hospitalization were considered. The study assessed quantitative data (laboratory results, administered antibiotics, Nutritional Risk Screening scores) and qualitative data (patient demographics, year of hospitalization, diarrhea upon admission, comorbidities, and in-hospital use of antibacterial drugs, proton pump inhibitors, and ranitidine).

The result showed that 319 adult patients diagnosed with CDI (178 women and 141 men) were included. A total of 80 patients (50 women and 30 men) died during hospitalization. The average patient was 72.08 years old (standard deviation ± 16.74 years). The study observed a morbidity rate of 174 cases per 100,000 hospitalizations and a mortality rate of 25.08%. Compared to patients surviving, the deceased group exhibited several characteristics: older by age, an average of 9.24 years, had hospital stays 10 days longer, and had lower albumin levels (Spearman’s rank correlation coefficient [Rho] = -0.235, P=<0.001). Additionally, the deceased group also had higher urea levels, received a more significant number of antibiotics, had a higher risk of malnutrition according to the Nutritional Risk Screening (NRS) score (Rho = 0.219, P=<0.001), and experienced a higher incidence of co-morbidities such as sepsis, heart failure, stroke, hypothyroidism, and pneumonia (diagnosed twice as often). The analysis also revealed that deceased patients were significantly more likely to administer penicillin and fluoroquinolone antibiotics compared to survivors.

Investigators concluded that patients diagnosed with CDI showed reduced morbidity but increased mortality rates linked to older age, multiple existing health conditions, extended hospital stays, frequent use of broad-spectrum antibiotics, and specific comorbidities such as heart failure and pneumonia.

Source: bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-024-09495-7