A Three-Year Analysis of Mortality in Clostridioides difficile Patients in a Tertiary Center

George S Gherlan; Simin Aysel Florescu; Mihaly Enyedi; Ion Cristian Efrem; Adina Mitrea; Diana Clenciu; Stefan D Lazar

doi:10.7759/cureus.74291

A Three-Year Analysis of Mortality in Clostridioides difficile Patients in a Tertiary Center

Cureus. 2024 Nov 23;16(11):e74291. doi: 10.7759/cureus.74291. eCollection 2024 Nov.

Authors

George S Gherlan^{1

2}, Simin Aysel Florescu^{1

2}, Mihaly Enyedi³, Ion Cristian Efrem⁴, Adina Mitrea⁵, Diana Clenciu⁵, Stefan D Lazar^{1

2}

Affiliations

¹ Infectious Diseases, Clinic Hospital of Tropical and Infection Diseases "Dr. Victor Babes", Bucharest, ROU.
² Infectious Diseases, University of Medicine and Pharmacy "Carol Davila", Bucharest, ROU.
³ Anatomy, University of Medicine and Pharmacy "Carol Davila", Bucharest, ROU.
⁴ Internal Medicine and Gastroenterology, University of Medicine and Pharmacy of Craiova, Craiova, ROU.
⁵ Diabetes and Endocrinology, University of Medicine and Pharmacy of Craiova, Craiova, ROU.

Abstract

Background/objectives: Clostridioides difficile, an anaerobic bacillus ubiquitous in nature, is the leading cause of hospital-acquired diarrhoea and one of the main causes of mortality by nosocomial infections. We aimed to identify the main predictors of the risk of dying and the characteristics of a three-year cohort of patients hospitalised in our clinic that eventually had an unfavourable outcome.

Methods: We collected retrospectively available data for all patients hospitalised between January 1, 2021, and December 31, 2023. The characteristics of the patients who died after the CDI (Clostridioides difficile infection) were analysed and compared with those of the patients who survived.

Results: In the three-year interval mentioned above, 1086 patients had the main or secondary diagnosis of CDI. Of these, 97 patients (8.93%) died. The overall mortality for the same period was 2.62%. Eight patients (8.24%) who died had the primary diagnosis of CDI, while in the entire group, the percentage of patients with a primary diagnosis was 54.7%. Statistically significant differences between the groups of deceased and survivor patients were found for the following parameters: age (p<0.001, 95% CI (confidence interval): 12.5-20.5), previous CDI episodes (p=0.033, 95% CI: 0.014-0.329), and for the following parameters measured at admission: systolic blood pressure, quick sepsis-related organ failure assessment (qSOFA), leucocyte count, haemoglobin, creatinine, albumin, potassium, INR (international normalised ratio), CRP (C-reactive protein), fibrinogen, and procalcitonin. The number of hospitalisation days for the patients who died was significantly higher (p<0.001, 95% CI: 4.3-12.6.).

Conclusions: We identified the characteristics that significantly differentiated the patients who died from those who survived. Mortality is significantly higher in the group of patients with CDI than that in the other hospitalised patients.

Keywords: clostridioides difficile; death; diarrhea; mortality; unfavourable prognostic.