title: Can we improve the therapy of Clostridium difficile infection in elderly patients?
abstract: BACKGROUND
  Clostridium difficile infection (CDI) is becoming a serious problem predominantly in geriatric patients, who are a significant risk group. The goal of this study was to evaluate the risk factors for mortality in CDI patients and to construct a binary logistic regression model that describes the probability of mortality in geriatric patients suffering from CDI.
  
  
  METHODS
  In this retrospective study, we evaluated a group of 235 patients over 65 years of age with confirmed diagnoses of CDI, hospitalized at the Department of Internal Medicine, Geriatrics and General Practice, Brno, from January 2008 to December 2013. The examined group comprised 148 women (63 %) and 87 men (37 %). For the diagnosis of CDI, confirmation of A and B toxins in the patients' stool or an autopsy confirmation was crucial.
  
  
  RESULTS
  The impact of antibiotic therapy on the increased incidence of CDI was clearly confirmed in our study group when examining patients' histories. Other risk factors included cerebrovascular disease, dementia, the presence of pressure ulcers, and immobility. Our new model consisted of a combination of the following parameters: the number of antibiotics used (from patients' history), nutritional status (Mini Nutritional Assessment short-form test), presence of pressure ulcers, and occurrence of fever.
  
  
  CONCLUSIONS
  Our logistic regression model may predict mortality in geriatric patients suffering from CDI. This could help improve the therapeutic process.
authors: Department of Internal Medicine, Geriatrics and General Practice, Faculty of Medicine, Masaryk University, Faculty Hospital Brno, Jihlavska 20, 62500, Brno, Czech Republic. bielakovak@seznam.cz.
authors: Katarina
authors: K
authors: Bielakova
authors: Department of Internal Medicine, Geriatrics and General Practice, Faculty of Medicine, Masaryk University, Faculty Hospital Brno, Jihlavska 20, 62500, Brno, Czech Republic.
authors: Emmanuela
authors: E
authors: Fernandova
authors: Department of Internal Medicine, Geriatrics and General Practice, Faculty of Medicine, Masaryk University, Faculty Hospital Brno, Jihlavska 20, 62500, Brno, Czech Republic.
authors: Hana
authors: H
authors: Matejovska-Kubesova
authors: Department of Internal Medicine, Geriatrics and General Practice, Faculty of Medicine, Masaryk University, Faculty Hospital Brno, Jihlavska 20, 62500, Brno, Czech Republic.
authors: Pavel
authors: P
authors: Weber
authors: Department of Internal Medicine, Geriatrics and General Practice, Faculty of Medicine, Masaryk University, Faculty Hospital Brno, Jihlavska 20, 62500, Brno, Czech Republic.
authors: Dana
authors: D
authors: Prudius
authors: Department of Statistics and Optimization, Faculty of Mechanical Engineering, Brno University of Technology, Brno, Czech Republic.
authors: Josef
authors: J
authors: Bednar
mesh_terms: D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D016360:Clostridioides difficile; D018153:Czech Republic / Q000453:epidemiology; D004761:Enterocolitis, Pseudomembranous / Q000382:microbiology / Q000401:mortality* / Q000628:therapy*; D005260:Female; D015577:Geriatric Assessment / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D008297:Male; D011379:Prognosis; D058996:Quality Improvement; D012307:Risk Factors; D017678:Sex Distribution; D015996:Survival Rate
chemical_list: D000900:Anti-Bacterial Agents
keywords: Antibiotic therapy; Binary logistic regression model; Clostridium difficile; Geriatric patient; Pseudomebranous colitis