Risk factors for recurrence, complications and mortality in Clostridium difficile infection: a systematic review.

<h4>Background</h4>Clostridium difficile infection (CDI) can lead to complications, recurrence, and death. Numerous studies have assessed risk factors for these unfavourable outcomes, but systematic reviews or meta-analyses published so far were limited in scope or in quality.<h4>M...

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Autores principales:	Claire Nour Abou Chakra, Jacques Pepin, Stephanie Sirard, Louis Valiquette
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2014
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/1c2289c23c37483d9beab4a99b311473
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spelling	oai:doaj.org-article:1c2289c23c37483d9beab4a99b3114732021-11-18T08:17:07ZRisk factors for recurrence, complications and mortality in Clostridium difficile infection: a systematic review.1932-620310.1371/journal.pone.0098400https://doaj.org/article/1c2289c23c37483d9beab4a99b3114732014-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/24897375/pdf/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background</h4>Clostridium difficile infection (CDI) can lead to complications, recurrence, and death. Numerous studies have assessed risk factors for these unfavourable outcomes, but systematic reviews or meta-analyses published so far were limited in scope or in quality.<h4>Methods</h4>A systematic review was completed according to PRISMA guidelines. An electronic search in five databases was performed. Studies published until October 2013 were included if risk factors for at least one CDI outcome were assessed with multivariate analyses.<h4>Results</h4>68 studies were included: 24 assessed risk factors for recurrence, 18 for complicated CDI, 8 for treatment failure, and 30 for mortality. Most studies accounted for mortality in the definition of complicated CDI. Important variables were inconsistently reported, such as previous episodes and use of antibiotics. Substantial heterogeneity and methodological limitations were noted, mainly in the sample size, the definition of the outcomes and periods of follow-up, precluding a meta-analysis. Older age, use of antibiotics after diagnosis, use of proton pump inhibitors, and strain type were the most frequent risk factors for recurrence. Older age, leucocytosis, renal failure and co-morbidities were frequent risk factors for complicated CDI. When considered alone, mortality was associated with age, co-morbidities, hypo-albuminemia, leucocytosis, acute renal failure, and infection with ribotype 027.<h4>Conclusion</h4>Laboratory parameters currently used in European and American guidelines to define patients at risk of a complicated CDI are adequate. Strategies for the management of CDI should be tailored according to the age of the patient, biological markers of severity, and underlying co-morbidities.Claire Nour Abou ChakraJacques PepinStephanie SirardLouis ValiquettePublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 9, Iss 6, p e98400 (2014)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Claire Nour Abou Chakra Jacques Pepin Stephanie Sirard Louis Valiquette Risk factors for recurrence, complications and mortality in Clostridium difficile infection: a systematic review.
description	<h4>Background</h4>Clostridium difficile infection (CDI) can lead to complications, recurrence, and death. Numerous studies have assessed risk factors for these unfavourable outcomes, but systematic reviews or meta-analyses published so far were limited in scope or in quality.<h4>Methods</h4>A systematic review was completed according to PRISMA guidelines. An electronic search in five databases was performed. Studies published until October 2013 were included if risk factors for at least one CDI outcome were assessed with multivariate analyses.<h4>Results</h4>68 studies were included: 24 assessed risk factors for recurrence, 18 for complicated CDI, 8 for treatment failure, and 30 for mortality. Most studies accounted for mortality in the definition of complicated CDI. Important variables were inconsistently reported, such as previous episodes and use of antibiotics. Substantial heterogeneity and methodological limitations were noted, mainly in the sample size, the definition of the outcomes and periods of follow-up, precluding a meta-analysis. Older age, use of antibiotics after diagnosis, use of proton pump inhibitors, and strain type were the most frequent risk factors for recurrence. Older age, leucocytosis, renal failure and co-morbidities were frequent risk factors for complicated CDI. When considered alone, mortality was associated with age, co-morbidities, hypo-albuminemia, leucocytosis, acute renal failure, and infection with ribotype 027.<h4>Conclusion</h4>Laboratory parameters currently used in European and American guidelines to define patients at risk of a complicated CDI are adequate. Strategies for the management of CDI should be tailored according to the age of the patient, biological markers of severity, and underlying co-morbidities.
format	article
author	Claire Nour Abou Chakra Jacques Pepin Stephanie Sirard Louis Valiquette
author_facet	Claire Nour Abou Chakra Jacques Pepin Stephanie Sirard Louis Valiquette
author_sort	Claire Nour Abou Chakra
title	Risk factors for recurrence, complications and mortality in Clostridium difficile infection: a systematic review.
title_short	Risk factors for recurrence, complications and mortality in Clostridium difficile infection: a systematic review.
title_full	Risk factors for recurrence, complications and mortality in Clostridium difficile infection: a systematic review.
title_fullStr	Risk factors for recurrence, complications and mortality in Clostridium difficile infection: a systematic review.
title_full_unstemmed	Risk factors for recurrence, complications and mortality in Clostridium difficile infection: a systematic review.
title_sort	risk factors for recurrence, complications and mortality in clostridium difficile infection: a systematic review.
publisher	Public Library of Science (PLoS)
publishDate	2014
url	https://doaj.org/article/1c2289c23c37483d9beab4a99b311473
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Risk factors for recurrence, complications and mortality in Clostridium difficile infection: a systematic review.

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