title: [Performance of prognostic index in severe Clostridium difficile-associated infection: retrospective analysis in a university hospital].
abstract: BACKGROUND
  By consensus severe, Clostridium difficile-associated infection (CDAI) is one that results in hospitalization in ICU, colectomy or death within 30 days. Multiple prognostic indices (IP) attempt to predict these adverse events.
  
  
  OBJECTIVE
  To evaluate the performance of 4 PI in predicting severe CDI.
  
  
  METHODS
  Hospitalized patients ≥ 18 years old with ICD were retrospectively evaluated. Patients with recurrent infection or hematological cancer were excluded. Four PI were evaluated: UPMC version 1, Calgary version 1, Hines VA and Calgary version 2.
  
  
  RESULTS
  Seven of 81 patients (8.1%) met the definition of severe CDI. Positive predicted value (PPV) and negative predicted value (NPV) of PI ranged from 20-75% and 91.3-95.7%, respectively. Only Hines VA index had a satisfactory Kappa index (0.74; 95% CI 0.41-1) with a PPV of 75% and NPV of 95,7%. However, because of the variables included, this PI could be calculated only in 32.6% of patients.
  
  
  CONCLUSIONS
  Hines VA index has the best predicted value and agreement to rule out a severe CDI. Like others PI it has the limitation of including difficult variables to assess in all patients and tends to overestimate an unfavorable course.
authors: Cristian
authors: C
authors: Hernández-Rocha
authors: Rodrigo
authors: R
authors: Tejos Sufan
authors: Ángela
authors: Á
authors: Plaza-Garrido
authors: Jonathan
authors: J
authors: Barra-Carrasco
authors: Carlos
authors: C
authors: Agüero Luengo
authors: Gonzalo
authors: G
authors: Inostroza Levy
authors: Patricio
authors: P
authors: Ibáñez Lazo
authors: Ana M
authors: AM
authors: Guzmán-Durán
authors: Daniel
authors: D
authors: Paredes-Sabja
authors: M Elena
authors: ME
authors: Molina Pezoa
authors: Manuel
authors: M
authors: Álvarez-Lobos
mesh_terms: D016360:Clostridioides difficile; D003015:Clostridium Infections / Q000401:mortality*; D005260:Female; D006785:Hospitals, University; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D012720:Severity of Illness Index