Garey et al developed an index for identifying a patient at risk for Clostridium difficile infection (CDI). This can help to identify a patient who may benefit from more aggressive management or a change in antibiotic therapy. The authors are from the University of Houston, University of Texas Houston, Baylor College of Medicine and St. Luke’s Episcopal Hospital.
Patient selection: hospitalized adult (>= 18 years old) receiving broad-spectrum antibiotics.
The authors reported two risk indices, one simple and one based on the odd ratios (OR) for the risk factors.
Parameters:
(1) age in years
(2) hemodialysis
(3) admission type
(4) number of weeks in the ICU
|
Parameter |
Finding |
Points for Simple |
Points for OR Index |
|
age |
< 50 years |
0 |
0 |
|
|
50 to 80 years |
1 |
1.5 |
|
|
> 80 years |
2 |
2.5 |
|
hemodialysis |
no |
0 |
0 |
|
|
yes |
1 |
1.5 |
|
admission type |
surgical |
0 |
0 |
|
|
other (non-surgical) |
1 |
2 |
|
number of weeks in ICU |
|
<weeks> |
2 * <weeks> |
where:
• The number of weeks in the ICU need not be a whole number.
total score for simple index =
= SUM(points for all 4 parameters using simple model)
total score for OR index =
= SUM(points for OR model)
Interpretation:
• minimum simple or OR index: 0
• maximum simple index: 4 + (number of weeks in ICU)
• maximum OR index: 6 + (2 * (number of weeks in ICU)
|
Total Simple Score |
Total OR Score |
Risk level |
|
< 3 |
0 to 3 |
low |
|
3 to 4 |
> 3 to 9.0 |
moderate |
|
> 4 to 6 |
> 9 to 11.5 |
high |
|
> 6 |
> 11.5 |
very high |
Specialty: Infectious Diseases, Gastroenterology
ICD-10: ,
