title: Clostridium difficile increases the risk for venous thromboembolism.
abstract: BACKGROUND
  Inflammatory bowel disease is associated with a higher risk for venous thromboembolism (VTE). Whether Clostridium difficile infection similarly increases this risk is unknown.
  
  
  METHODS
  This was a retrospective analysis of patients admitted to the surgical intensive care unit (ICU) at the Cedars-Sinai Medical Center from February 2011 to July 2013. The 2 groups were compared using standard statistical methodology.
  
  
  RESULTS
  During the 30-month study period, a total of 1,728 patients were admitted to the surgical ICU. A total of 64 patients (3.7%) tested positive for C. difficile. The use of chemical prophylaxis for VTE was significantly higher in the C. difficile group (64.1% vs 46.2%, P = .005). Nonetheless, C. difficile patients had a higher risk for development of a VTE (23.4% vs 11.0%, adjusted odds ratio [95% confidence interval]: 1.87 [1.01 to 3.48], P = .048). In a forward logistic regression model, C. difficile was found to be independently associated with the development of VTE (adjusted odds ratio [95% confidence interval]: 1.87 [1.00 to 3.47], P = .049).
  
  
  CONCLUSIONS
  C. difficile infection increases the risk for VTE in surgical patients admitted to the ICU.
authors.affiliation: Division of Acute Care Surgery and Surgical Critical Care, Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
authors.forename: Galinos
authors.initials: G
authors.lastname: Barmparas
authors.affiliation: Division of Acute Care Surgery and Surgical Critical Care, Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
authors.forename: Nicole
authors.initials: N
authors.lastname: Fierro
authors.affiliation: Division of Acute Care Surgery and Surgical Critical Care, Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
authors.forename: Alexander W
authors.initials: AW
authors.lastname: Lamb
authors.affiliation: Division of Acute Care Surgery and Surgical Critical Care, Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
authors.forename: Debora
authors.initials: D
authors.lastname: Lee
authors.affiliation: Division of Acute Care Surgery and Surgical Critical Care, Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
authors.forename: Brandon
authors.initials: B
authors.lastname: Nguyen
authors.affiliation: Division of Acute Care Surgery and Surgical Critical Care, Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
authors.forename: Daniel H
authors.initials: DH
authors.lastname: Tran
authors.affiliation: Division of Acute Care Surgery and Surgical Critical Care, Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
authors.forename: Rex
authors.initials: R
authors.lastname: Chung
authors.affiliation: Division of Acute Care Surgery and Surgical Critical Care, Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA. Electronic address: Eric.Ley@cshs.org.
authors.forename: Eric J
authors.initials: EJ
authors.lastname: Ley
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D016360:Clostridioides difficile / Q000302:isolation & purification; D003015:Clostridium Infections / Q000150:complications* / Q000175:diagnosis; D003422:Critical Care; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D012189:Retrospective Studies; D012307:Risk Factors; D054556:Venous Thromboembolism / Q000209:etiology*
keywords: C. difficile; Colitis; Deep venous thrombosis; Pulmonary embolus; Venous thromboembolism