Chattanooga-based University of Tennessee College of Medicine researchers have identified five variables that may help clinicians develop a clinical prediction tool for guiding treatment decisions in severe cases of Clostridium difficile infection, according to General Surgery News.
The findings of the University of Tennessee College of Medicine were presented by Matthew Figh, MD, chief surgery resident at the institution at a recent meeting of the Southeastern Surgical Congress.
"We would like to identify and isolate the patients who would benefit from this," said Dr. Figh. "The ultimate question now is when is a case likely futile? A clinical prediction tool would be very useful in helping to identify those patients."
Dr. Figh and the University of Tennessee College of Medicine researchers worked to determine a combination of risk factors that would identify patients most likely to die with surgical intervention by examining data on 876 patients with CDI between 2003 and 2010, 82 (9.3 percent) of whom died. They looked at 32 variables taken at the time of admission, the time of diagnosis of CDI and 48 hours after CDI diagnosis.
Of the 32 variables studied, the researchers found the following five were statistically significant in predicting mortality.
1. Age greater than 60 years
2. Use of vasopressor agents at time of diagnosis
3. Acute renal disease at time of diagnosis
4. Chronic renal disease at time of diagnosis
5. Albumin rates of less than 3.0 grams per deciLiter
"Most of these are actually comorbidities, but our aim was to find risk factors associated with morbidity and mortality," Dr. Figh said. The five variables "represent an overall deterioration of normal physiology, and they do not exist in a vacuum. We believe it is a combination of these factors [that determines] the overall severity."
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