title: Clinical Outcomes in Hospitalized Patients with Clostridium difficile Infection by Age Group.
abstract: OBJECTIVE
  Advanced age is a known risk factor of poor outcomes for colitis, including Clostridium difficile infection (CDI). The present study compares the clinical outcomes of young and old patients hospitalized for CDI.
  
  
  METHODS
  The clinical records of patients admitted from January 2007 to December 2013 with a diagnosis of CDI were analyzed. Patient baseline characteristics, clinical courses, and outcomes were compared with respect to age using a cut-off 65 years.
  
  
  RESULTS
  Of the 241,391 inpatients registered during the study period, 225 (0.1%) with a diagnosis of CDI were included in the study. The mean patient age was 67.7 years. Seventy-two patients (32.0%) were younger than 65 years and 153 patients (68.0%) were 65 years old or more. The male to female ratio in the younger group was 0.8, and 0.58 in the older group. All 225 study subjects had watery diarrhea; six patients (8.3%) complained of bloody diarrhea in the young group and 21 patients (13.7%) in the old group (p=0.246). Right colon involvement was more common in the old group (23.5% vs. 42.7%, p=0.033). Furthermore, leukocytosis (41.7% vs. 67.3%, p=0.000), a CDI score of ≥ 3 points (77.8% vs. 89.5%, p=0.018), and hypoalbuminemia (58.3% vs. 76.5%, p=0.005) were more common in the old group. Failure to first line treatment was more common in the old group (17 [23.6%] vs. 58 [37.9%], p=0.034).
  
  
  CONCLUSIONS
  Severe colitis and failure to first line treatment were significantly more common in patients age 65 years or more. More aggressive initial treatment should be considered for older CDI patients.
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea.
authors.forename: Ho Chan
authors.initials: HC
authors.lastname: Lee
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea.
authors.forename: Kyeong Ok
authors.initials: KO
authors.lastname: Kim
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea.
authors.forename: Yo Han
authors.initials: YH
authors.lastname: Jeong
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea.
authors.forename: Si Hyung
authors.initials: SH
authors.lastname: Lee
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea.
authors.forename: Byung Ik
authors.initials: BI
authors.lastname: Jang
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea.
authors.forename: Tae Nyeun
authors.initials: TN
authors.lastname: Kim
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000419:Albuminuria / Q000209:etiology; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D003015:Clostridium Infections / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D003967:Diarrhea / Q000150:complications; D005260:Female; D006760:Hospitalization; D006801:Humans; D007964:Leukocytosis / Q000209:etiology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index
chemical_list: D000900:Anti-Bacterial Agents
keywords: Clostridium difficile infection; Elderly; Severity; Treatment