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三级医疗中心艰难梭菌感染患者死亡率的三年分析

A Three-Year Analysis of Mortality in Clostridioides difficile Patients in a Tertiary Center.

作者信息

Gherlan George S, Florescu Simin Aysel, Enyedi Mihaly, Efrem Ion Cristian, Mitrea Adina, Clenciu Diana, Lazar Stefan D

机构信息

Infectious Diseases, Clinic Hospital of Tropical and Infection Diseases "Dr. Victor Babes", Bucharest, ROU.

Infectious Diseases, University of Medicine and Pharmacy "Carol Davila", Bucharest, ROU.

出版信息

Cureus. 2024 Nov 23;16(11):e74291. doi: 10.7759/cureus.74291. eCollection 2024 Nov.

Abstract

BACKGROUND/OBJECTIVES: , an anaerobic bacillus ubiquitous in nature, is the leading cause of hospital-acquired diarrhoea and one of the main causes of mortality by nosocomial infections. We aimed to identify the main predictors of the risk of dying and the characteristics of a three-year cohort of patients hospitalised in our clinic that eventually had an unfavourable outcome.

METHODS

We collected retrospectively available data for all patients hospitalised between January 1, 2021, and December 31, 2023. The characteristics of the patients who died after the CDI ( infection) were analysed and compared with those of the patients who survived.

RESULTS

In the three-year interval mentioned above, 1086 patients had the main or secondary diagnosis of CDI. Of these, 97 patients (8.93%) died. The overall mortality for the same period was 2.62%. Eight patients (8.24%) who died had the primary diagnosis of CDI, while in the entire group, the percentage of patients with a primary diagnosis was 54.7%. Statistically significant differences between the groups of deceased and survivor patients were found for the following parameters: age (p<0.001, 95% CI (confidence interval): 12.5-20.5), previous CDI episodes (p=0.033, 95% CI: 0.014-0.329), and for the following parameters measured at admission: systolic blood pressure, quick sepsis-related organ failure assessment (qSOFA), leucocyte count, haemoglobin, creatinine, albumin, potassium, INR (international normalised ratio), CRP (C-reactive protein), fibrinogen, and procalcitonin. The number of hospitalisation days for the patients who died was significantly higher (p<0.001, 95% CI: 4.3-12.6.).

CONCLUSIONS

We identified the characteristics that significantly differentiated the patients who died from those who survived. Mortality is significantly higher in the group of patients with CDI than that in the other hospitalised patients.

摘要

背景/目的:艰难梭菌是一种自然界中普遍存在的厌氧芽孢杆菌,是医院获得性腹泻的主要原因,也是医院感染致死的主要原因之一。我们旨在确定死亡风险的主要预测因素,以及在我们诊所住院的最终结局不佳的患者三年队列的特征。

方法

我们回顾性收集了2021年1月1日至2023年12月31日期间所有住院患者的可用数据。分析了艰难梭菌感染(CDI)后死亡患者的特征,并与存活患者的特征进行了比较。

结果

在上述三年期间,1086例患者有CDI的主要或次要诊断。其中,97例(8.93%)死亡。同期总死亡率为2.62%。8例(8.24%)死亡患者的主要诊断为CDI,而在整个组中,主要诊断患者的百分比为54.7%。在死亡患者组和存活患者组之间,发现以下参数存在统计学显著差异:年龄(p<0.001,9

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/53b6/11666302/a90305c58fbb/cureus-0016-00000074291-i01.jpg

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