title: Application of the ATLAS score for evaluating the severity of Clostridium difficile infection in teaching hospitals in Mexico.
abstract: BACKGROUND
  For clinicians, a practical bedside tool for severity assessment and prognosis of patients with Clostridium difficile infection is a highly desirable unmet medical need.
  
  
  METHODS
  Two general teaching hospitals in northeast Mexico.
  
  
  METHODS
  Adult patients with C. difficile infection.
  
  
  METHODS
  Prospective observational study.
  
  
  RESULTS
  Patients included had a median of 48 years of age, 54% of male gender and an average of 24.3 days length of hospital stay. Third generation cephalosporins were the antibiotics most commonly used prior to C. difficile infection diagnosis. Patients diagnosed with C. difficile infection had a median ATLAS score of 4 and 56.7% of the subjects had a score between 4 and 7 points. Patients with a score of 8 through 10 points had 100% mortality.
  
  
  CONCLUSIONS
  The ATLAS score is a potentially useful tool for the routine evaluation of patients at the time of C. difficile infection diagnosis. At 30 days post-diagnosis, patients with a score of ≤3 points had 100% survival while all of those with scores ≥8 died. Patients with scores between 4 and 7 points had a greater probability of colectomy with an overall cure rate of 70.1%.
authors.affiliation: Coordinación de Epidemiología Hospitalaria, Hospital Universitario Dr José Eleuterio González, Universidad Autónoma de Nuevo León, Monterrey, Mexico.
authors.forename: Raúl
authors.initials: R
authors.lastname: Hernández-García
authors.affiliation: Servicio de Gastroenterología, Hospital Universitario Dr José Eleuterio González, Universidad Autónoma de Nuevo León, Monterrey, Mexico.
authors.forename: Elvira
authors.initials: E
authors.lastname: Garza-González
authors.affiliation: Division of Infectious Diseases, McGill University, Montreal, Canada.
authors.forename: Mark
authors.initials: M
authors.lastname: Miller
authors.affiliation: Departamento de Medicina Interna, Hospital Christus Muguerza alta Especialidad, Nuevo León, Monterrey, Mexico.
authors.forename: Giovanna
authors.initials: G
authors.lastname: Arteaga-Muller
authors.affiliation: Coordinación de Epidemiología Hospitalaria, Hospital Universitario Dr José Eleuterio González, Universidad Autónoma de Nuevo León, Monterrey, Mexico.
authors.forename: Alejandra María
authors.initials: AM
authors.lastname: Galván-de los Santos
authors.affiliation: Coordinación de Epidemiología Hospitalaria, Hospital Universitario Dr José Eleuterio González, Universidad Autónoma de Nuevo León, Monterrey, Mexico. Electronic address: acamacho_md@yahoo.com.
authors.forename: Adrián
authors.initials: A
authors.lastname: Camacho-Ortiz
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016360:Clostridioides difficile; D003015:Clostridium Infections / Q000145:classification / Q000175:diagnosis* / Q000401:mortality; D005260:Female; D006784:Hospitals, Teaching; D006801:Humans; D007902:Length of Stay; D008297:Male; D008800:Mexico; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D012720:Severity of Illness Index; D055815:Young Adult
keywords: Clostridium difficile; Mortality; Prediction rule