MELD is the only predictor of short-term mortality in cirrhotic patients with C. difficile infection

Digestive and Liver Disease : Official Journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver
Simon J HongLawrence J Brandt

Abstract

Clostridium difficile infection (CDI) is the most common nosocomial infection in the US and cirrhotic patients with CDI have increased risk for poor outcome. The aim of this study is to evaluate the impact of CDI on short-term mortality in patients with cirrhosis and identify predictors of mortality in these patients. We retrospectively identified patients at Montefiore Medical Center from 2010 to 2014 with cirrhosis, diarrhea and a C. difficile toxin assay. Demographics, co-morbidities, medications, laboratory data and outcomes were recorded. Of 701 patients with cirrhosis who had a CDI assay, 183 were CDI+ and 518 CDI-. Patients with CDI were older, had more frequent CKD on hemodialysis and heart failure, were less frequently on rifaximin and lactulose and had increased glucocorticoid exposure. 30-day mortality was higher in patients with CDI (23.0% vs 16.6%, p < 0.05) compared to those without. Univariate predictors of 30-day mortality included WBC, corticosteroid use, AST, ALT, MELD, albumin, HBV and HCV infection; however, via multivariate analysis, only MELD (HR: 1.04 ± 0.02, p < 0.05) remained significant. Patients with cirrhosis and CDI are at greater risk of 30-day mortality than those without CDI and the only multivar...Continue Reading

Citations

Aug 24, 2019·Digestive Diseases and Sciences·Paul FeuerstadtLawrence J Brandt
Jun 12, 2021·Clinical and Experimental Gastroenterology·Nikhitha MantriSuresh Kumar Nayudu
Jul 3, 2021·Antibiotics·Mirela Nicoleta VoicuBogdan Silviu Ungureanu

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