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KMID : 1188320140080010041
Gut and Liver
2014 Volume.8 No. 1 p.41 ~ p.48
The Simple Predictors of Pseudomembranous Colitis in Patients with Hospital-Acquired Diarrhea: A Prospective Observational Study
Yang Bo-Kyung

Do Byung-Ju
Kim Eun-Jung
Lee Ji-Un
Kim Mi-Hee
Kang Jin-Gu
Kim Hyoung-Su
Kim Kyung-Ho
Jang Myoung-Kuk
Lee Jin-Heon
Kim Hak-Yang
Shin Woon-Geon
Abstract
Background/Aims:As the incidence rate of and mortality from pseudomembranous colitis (PMC) are increasing worldwide, it is important to study the simple predictive risk factors for PMC among patients with hospital-acquired diarrhea (HAD). This study focused on identifying the clinical risk factors that can easily predict PMC.

Methods:The presumed HAD patients were prospectively recruited at the Hallym University Kangdong Sacred Heart Hospital.

Results:Age of 70 and older (adjusted odds ratio [OR], 1.76; 95% confidence interval [CI], 1.12 to 0.75), use of proton pump inhibitors (adjusted OR, 4.07; 95% CI, 2.512 to 6.57), use of cephalosporins (adjusted OR, 2.99; 95% CI, 1.82 to 4.94), and underlying cancer (adjusted OR, 1.72; 95% CI, 1.04 to 2.82) were independent risk factors for PMC in the multivariate logistic regression analysis. The prevalence of PMC was very low in the patients with HAD who exhibited no risk factors.

Conclusions:The risk factors for PMC in patients with HAD included cephalosporin use, proton pump inhibitor use, old age, and cancer. Considering the strongly negative predictive values of these risk factors, endoscopic evaluation can be delayed in patients with HAD without risk of developing PMC.
KEYWORD
Enterocolitis, pseudomembranous, Clostridium difficile, Risk factors, Predictors
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