Evaluation of a risk score to predict future Clostridium difficile disease using UK primary care and hospital data in Clinical Practice Research Datalink

Autor: Laura M. Woods, Germano Ferreira, Ana Ramirez Villaescusa, Clare Marley, Yassine El Hahi
Jazyk: angličtina
Rok vydání: 2019
Předmět:
Male
Multivariate statistics
genetic structures
Logistic regression
0302 clinical medicine
Risk Factors
Hospital-acquired infection
Immunology and Allergy
030212 general & internal medicine
education.field_of_study
Cross Infection
Framingham Risk Score
hospital-acquired infection
Incidence
Middle Aged
community-acquired infection
Anti-Bacterial Agents
Hospitalization
risk index
nosocomial infection
Clinical Practice Research Datalink
Hospital Episode Statistics
Female
Research Paper
Adult
medicine.medical_specialty
Adolescent
030231 tropical medicine
Immunology
Population
03 medical and health sciences
Young Adult
medicine
Humans
Risk factor
education
Aged
Retrospective Studies
Pharmacology
Primary Health Care
business.industry
Clostridioides difficile
Retrospective cohort study
Clostridium difficile
medicine.disease
United Kingdom
Logistic Models
Relative risk
Emergency medicine
Clostridium Infections
business
Zdroj: Human Vaccines & Immunotherapeutics
ISSN: 2164-554X
2164-5515
Popis: We evaluated the applicability of a Clostridium difficile infection (CDI) risk index developed for patients at hospital discharge to identify persons at high-risk of CDI in a primary care population. This retrospective observational study used data from the UK Clinical Practice Research Datalink, linked with Hospital Episodes Statistics. The risk index was based on the following patient characteristics: age, previous hospitalizations, days in hospital, and prior antibiotics use. Individual risk scores were calculated by summing points assigned to pre-defined categories for each characteristic. We assessed the association of risk factors with CDI by multivariate logistic regression. The estimated CDI incidence rate was 4/10,000 and 2/10,000 person-years in 2008 and 2012, respectively. On an index with a maximal risk of 19, a cut-off for high risk of ≥7 had sensitivity, specificity and positive predictive values of 80%, 87% and 12%, respectively. A high-risk person had a ~ 35% higher risk of CDI than a low-risk person. Multivariate risk factor analysis indicated a need to reconsider the relative risk scores. The CDI risk index can be applied to the UK primary care population and help identify study populations for vaccine development studies. Reassessing the relative weights assigned to risk factors could improve the index performance in this setting.
Databáze: OpenAIRE
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