Benitez Gregorio, Shehadeh Fadi, Kalligeros Markos, Mylona Evangelia K, Tran Quynh-Lam, Zacharioudakis Ioannis M, Mylonakis Eleftherios
Infectious Diseases Division, Warren Alpert Medical School of Brown University, Providence, RI 02903, USA.
School of Electrical and Computer Engineering, National Technical University of Athens, 15780 Athens, Greece.
Pathogens. 2022 May 8;11(5):555. doi: 10.3390/pathogens11050555.
(1) Background: infection (CDI) is associated with a high recurrence rate, and a significant proportion of patients with CDI are readmitted following discharge. We aimed to identify the risk factors for CDI-related readmission within 90 days following an index hospital stay for CDI. (2) Methods: We analyzed the electronic medical data of admitted patients in our health system over a two-year period. A multivariate logistic regression model, supplemented with bias-corrected and accelerated confidence intervals (BCa-CI), was implemented to assess the risk factors. (3) Results: A total of 1253 adult CDI index cases were included in the analysis. The readmission rate for CDI within 90 days of discharge was 11% (140/1253). The risk factors for CDI-related readmission were fluoroquinolone exposure within 90 days before the day of index CDI diagnosis (aOR: 1.58, 95% CI: 1.05-2.37), higher Elixhauser comorbidity score (aOR: 1.05, 95% CI: 1.02-1.07), and being discharged home (aOR: 1.64, 95% CI: 1.06-2.54). In contrast, a longer length of index stay (aOR: 0.97, 95% BCa-CI: 0.95-0.99) was associated with reduced odds of readmission for CDI. (4) Conclusion: More than 1 out of 10 patients were readmitted for CDI following an index hospital stay for CDI. Patients with recent previous fluoroquinolone exposure, greater overall comorbidity burden, and those discharged home are at higher risk of readmission for CDI.
(1)背景:艰难梭菌感染(CDI)与高复发率相关,且相当一部分CDI患者出院后再次入院。我们旨在确定在因CDI首次住院后90天内与CDI相关再入院的风险因素。(2)方法:我们分析了我们医疗系统中两年期间收治患者的电子医疗数据。采用多变量逻辑回归模型,并辅以偏差校正和加速置信区间(BCa-CI)来评估风险因素。(3)结果:分析共纳入1253例成人CDI首次病例。出院后90天内CDI的再入院率为11%(140/1253)。与CDI相关再入院的风险因素为在首次CDI诊断日前90天内使用氟喹诺酮类药物(调整后比值比:1.58,95%置信区间:1.05-2.37)、较高的埃利克斯豪泽合并症评分(调整后比值比:1.05,95%置信区间:1.02-1.07)以及出院回家(调整后比值比:1.64,95%置信区间:1.06-2.54)。相比之下,首次住院时间较长(调整后比值比:0.97,95% BCa-CI:0.95-0.99)与CDI再入院几率降低相关。(4)结论:超过十分之一的患者在因CDI首次住院后因CDI再次入院。近期曾使用氟喹诺酮类药物、总体合并症负担较重以及出院回家的患者CDI再入院风险较高。