Predicting the risk for hospital-onset Clostridium difficile infection (HO-CDI) at the time of inpatient admission: HO-CDI risk score

Infection Control and Hospital Epidemiology : the Official Journal of the Society of Hospital Epidemiologists of America
Ying P TabakL Clifford McDonald

Abstract

To predict the likelihood of hospital-onset Clostridium difficile infection (HO-CDI) based on patient clinical presentations at admission Retrospective data analysis Six US acute care hospitals Adult inpatients We used clinical data collected at the time of admission in electronic health record (EHR) systems to develop and validate a HO-CDI predictive model. The outcome measure was HO-CDI cases identified by a nonduplicate positive C. difficile toxin assay result with stool specimens collected >48 hours after inpatient admission. We fit a logistic regression model to predict the risk of HO-CDI. We validated the model using 1,000 bootstrap simulations. Among 78,080 adult admissions, 323 HO-CDI cases were identified (ie, a rate of 4.1 per 1,000 admissions). The logistic regression model yielded 14 independent predictors, including hospital community onset CDI pressure, patient age ≥65, previous healthcare exposures, CDI in previous admission, admission to the intensive care unit, albumin ≤3 g/dL, creatinine >2.0 mg/dL, bands >32%, platelets ≤150 or >420 109/L, and white blood cell count >11,000 mm3. The model had a c-statistic of 0.78 (95% confidence interval [CI], 0.76-0.81) with good calibration. Among 79% of patients with risk...Continue Reading

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Citations

Jan 19, 2016·American Journal of Infection Control·Alba Cruz-BetancourtVincent Hsu
Oct 13, 2015·Infection Control and Hospital Epidemiology : the Official Journal of the Society of Hospital Epidemiologists of America·Ying P TabakL Clifford McDonald
Oct 13, 2015·Infection Control and Hospital Epidemiology : the Official Journal of the Society of Hospital Epidemiologists of America·Stefano Di BellaNicola Petrosillo
Dec 8, 2016·Infection Control and Hospital Epidemiology : the Official Journal of the Society of Hospital Epidemiologists of America·Jerry JacobDeborah B Nelson
Sep 12, 2016·Journal of Thrombosis and Thrombolysis·Eric M FountainGowthami M Arepally
Mar 19, 2015·Infection Control and Hospital Epidemiology : the Official Journal of the Society of Hospital Epidemiologists of America·Rachel B SlaytonJohn A Jernigan
Jul 26, 2019·Infection Control and Hospital Epidemiology : the Official Journal of the Society of Hospital Epidemiologists of America·Jenine R LealPaul Ronksley
Oct 28, 2019·Infection Control and Hospital Epidemiology : the Official Journal of the Society of Hospital Epidemiologists of America·Kristen BushMartin S Zand
Aug 24, 2019·Emerging Infectious Diseases·Mini KambojAllison Lipitz-Snyderman
Jul 27, 2018·Open Forum Infectious Diseases·Margaret A OlsenErik R Dubberke
Dec 11, 2019·Journal for Healthcare Quality : Official Publication of the National Association for Healthcare Quality·Neeraj PuroMidge Ray
Dec 18, 2020·Infection Control and Hospital Epidemiology : the Official Journal of the Society of Hospital Epidemiologists of America·Stephanie M CabralAnthony D Harris
Oct 11, 2021·Current Opinion in Gastroenterology·Krishna Rao, Erik R Dubberke

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