Risk Factors of Valiquette et al for Complicated Clostridium difficile Colitis

 

Criteria for complicated Clostridium difficile colitis:

(1) death within 30 days of diagnosis

(2) megacolon

(3) perforation

(4) colectomy

(5) shock requiring vasopressors therapy

 

Parameters:

(1) pleural effusion on CT scan

(2) colonic wall thickness on CT scan

(3) serum albumin

(4) peak white blood cell count

(5) immune status

 

Parameter	Finding	Points
pleural effusion	absent	0
	present	1
colonic wall thickness	<= 15 mm	0
	> 15 mm	1
serum albumin	>= 2.0 g/dL	0
	< 2.0 g/dL	1
peak WBC count	< 30,000 per µL	0
	>= 30,000 per µL	1
immune status	normal	0
	immunosuppressed	1

 

where:

• The adjusted odds ratios varied from 2.6 to 6.9 (pleural effusion 2.6; immunosuppression 4.7; peak WBC count 4.8; colon wall thickness 6.0; albumin 6.9)

 

number of risk factors =

= SUM(points for all 5 parameters)

 

Interpretation:

• minimum number of risk factors: 0

• maximum number of risk factors: 5

• The higher the number of risk factors the greater the risk of the patient following a complicated course.