A Propensity Score Analysis of Clostridium difficile Infection among Adult Trauma Patients
| Autor: | Areg Grigorian, Jacquelyn L Phillips, Jeffry Nahmias, Viktor Gabriel, Marija Pejcinovska, Cristobal Barrios, Sebastian D. Schubl, Eugene Won |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
0301 basic medicine
Microbiology (medical) Male medicine.medical_specialty 030106 microbiology 03 medical and health sciences 0302 clinical medicine Injury Severity Score Risk Factors Internal medicine Hospital-acquired infection medicine Humans 030212 general & internal medicine Propensity Score Retrospective Studies business.industry Clostridioides difficile Mortality rate Clostridium difficile Length of Stay Middle Aged medicine.disease Intensive Care Units Infectious Diseases Propensity score matching Clostridium Infections Wounds and Injuries Surgery Female business |
| Zdroj: | Surgical infections. 19(7) |
| ISSN: | 1557-8674 |
| Popis: | Clostridium difficile infection (CDI) is now the most common cause of health-care-associated infection and carries a mortality rate ranging from 5-30%. Previously, trauma patients in whom CDI developed were thought to represent a unique younger at-risk population. This study aimed to establish the incidence of CDI among adult trauma patients. We hypothesized that these patients would have increased risk of death, intensive care unit (ICU) length of stay (LOS), and hospital LOS compared with trauma patients without CDI.A retrospective study of all adult trauma patients admitted for greater than 48 hours to a single Level I trauma center between 2014 and 2016 was conducted. Analysis was performed using 1-to-5 propensity score matching with the aim to analyze the relationship between CDI, death, and other outcome variables.Between 2014 and 2016, of 4893 trauma patients admitted for48 hours, 27 (0.6%) patients received a diagnosis of CDI. These patients had a mean age of 55.6 years, mean injury severity score (ISS) of 22.4, and mortality rate of 9.1%. Of these patients, 22 were able to find appropriate propensity score matches. After adjusting for important covariables, there was no significant difference in death between CDI and non-CDI patients (odds ratio = 0.39, 95% confidence interval [CI]: 0.06-2.57, adjusted p = 0.66). In addition, there was no significant difference in ICU LOS between the two groups (relative mean [RM]: 1.55, 95% CI: 1.04-2.33, adjusted p = 0.0971). The CDI patients, however, did have a significantly longer hospital LOS, compared with non-CDI patients (RM = 1.39, 95% CI: 1.16-1.66, adjusted p = 0.0017).Among trauma patients admitted48 hours CDI occurred at a rate of 0.6%, much lower than anticipated. Patients in whom CDI developed had a significantly longer hospital LOS however, had no significant difference in odds of mortality or ICU LOS compared to patients without CDI. |
| Databáze: | OpenAIRE |
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