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2016 ; 43
(6
): 725-33
Nephropedia Template TP
gab.com Text
Twit Text FOAVip
Twit Text #
English Wikipedia
Clostridium difficile associated risk of death score (CARDS): a novel severity
score to predict mortality among hospitalised patients with C difficile
infection
#MMPMID26849527
Kassam Z
; Cribb Fabersunne C
; Smith MB
; Alm EJ
; Kaplan GG
; Nguyen GC
; Ananthakrishnan AN
Aliment Pharmacol Ther
2016[Mar]; 43
(6
): 725-33
PMID26849527
show ga
BACKGROUND: Clostridium difficile infection (CDI) is a public health threat and
associated with significant mortality. However, there is a paucity of objectively
derived CDI severity scoring systems to predict mortality. AIM: To develop a
novel CDI risk score to predict mortality entitled: Clostridium difficile
associated risk of death score (CARDS). METHODS: We obtained data from the United
States 2011 Nationwide Inpatient Sample (NIS) database. All CDI-associated
hospitalisations were identified using discharge codes (ICD-9-CM, 008.45).
Multivariate logistic regression was utilised to identify independent predictors
of mortality. Clostridium difficile associated risk of death score was calculated
by assigning a numeric weight to each parameter based on their odds ratio in the
final logistic model. Predictive properties of model discrimination were assessed
using the c-statistic and validated in an independent sample using the 2010 NIS
database. RESULTS: We identified 77 776 hospitalisations, yielding an estimate of
374 747 cases with an associated diagnosis of CDI in the US, 8% of whom died in
the hospital. The eight severity score predictors were identified on multivariate
analysis: age, cardiopulmonary disease, malignancy, diabetes, inflammatory bowel
disease, acute renal failure, liver disease and ICU admission, with weights
ranging from -1 (for diabetes) to 5 (for ICU admission). The overall risk score
in the cohort ranged from 0 to 18. Mortality increased significantly as CARDS
increased. CDI-associated mortality was 1.2% with a CARDS of 0 compared to 100%
with CARDS of 18. The model performed equally well in our validation cohort.
CONCLUSION: Clostridium difficile associated risk of death score is a promising
simple severity score to predict mortality among those hospitalised with C.
difficile infection.