Idan Goren, Ortal Fallek Boldes, Tomer Boldes, Oleg Knyazev, Anna Kagramanova, Jimmy K Limdi, Eleanor Liu, Karishma Sethi-Arora, Tom Holvoet, Piotr Eder, Cristina Bezzio, Simone Saibeni, Marta Vernero, Eleonora Alimenti, María Chaparro, Javier P Gisbert, Eleni Orfanoudaki, Ioannis E Koutroubakis, Daniela Pugliese, Giuseppe Cuccia, Cristina Calviño Suarez, Davide Giuseppe Ribaldone, Ido Veisman, Kassem Sharif, Annalisa Aratari, Claudio Papi, Iordanis Mylonas, Gerassimos J Mantzaris, Marie Truyens, Triana Lobaton, Stéphane Nancey, Fabiana Castiglione, Olga Maria Nardone, Giulio Calabrese, Konstantinos Karmiris, Magdalini Velegraki, Angeliki Theodoropoulou, Ariella Bar-Gil Shitrit, Milan Lukas, Gabriela Vojtechová, Pierre Ellul, Luke Bugeja, Edoardo V Savarino, Tali Sharar Fischler, Iris Dotan, Henit Yanai
{"title":"Post-Discharge Outcomes of Elderly Patients Hospitalized for Inflammatory Bowel Disease Flare Complicated by Clostridioides difficile Infection.","authors":"Idan Goren, Ortal Fallek Boldes, Tomer Boldes, Oleg Knyazev, Anna Kagramanova, Jimmy K Limdi, Eleanor Liu, Karishma Sethi-Arora, Tom Holvoet, Piotr Eder, Cristina Bezzio, Simone Saibeni, Marta Vernero, Eleonora Alimenti, María Chaparro, Javier P Gisbert, Eleni Orfanoudaki, Ioannis E Koutroubakis, Daniela Pugliese, Giuseppe Cuccia, Cristina Calviño Suarez, Davide Giuseppe Ribaldone, Ido Veisman, Kassem Sharif, Annalisa Aratari, Claudio Papi, Iordanis Mylonas, Gerassimos J Mantzaris, Marie Truyens, Triana Lobaton, Stéphane Nancey, Fabiana Castiglione, Olga Maria Nardone, Giulio Calabrese, Konstantinos Karmiris, Magdalini Velegraki, Angeliki Theodoropoulou, Ariella Bar-Gil Shitrit, Milan Lukas, Gabriela Vojtechová, Pierre Ellul, Luke Bugeja, Edoardo V Savarino, Tali Sharar Fischler, Iris Dotan, Henit Yanai","doi":"10.1093/ecco-jcc/jjae161","DOIUrl":null,"url":null,"abstract":"<p><strong>Objectives: </strong>Elderly hospitalized patients with inflammatory bowel disease (IBD) flare and concurrent Clostridioides difficile infection (CDI) are considered at high risk of IBD-related complications. We aimed to evaluate the short, intermediate, and long-term post-discharge complications among these patients.</p><p><strong>Methods: </strong>A retrospective multicenter cohort study assessing outcomes of elderly individuals (≥60 years) hospitalized for an IBD flare who were tested for CDI (either positive or negative) and discharged. The primary outcome was the 3-months post-discharge IBD-related complication rates defined as: steroid dependency, re-admissions (emergency department or hospitalization), IBD-related surgery, or mortality. We assessed post-discharge IBD-related complications within 6-months and mortality at 12-months among secondary outcomes. Risk factors for complication were assessed by multivariable logistic regression.</p><p><strong>Results: </strong>In a cohort of 654 patients hospitalized for IBD (age 68.9 [interquartile range {IQR}]:63.9-75.2) years, 60.9% ulcerative colitis), 23.4% were CDI-positive. Post-discharge complication rates at 3 and 6-months, and 12-months mortality, did not differ significantly between CDI-positive and CDI-negative patients (32% vs. 33.1%, p=0.8; 40.5% vs. 42.5%, p=0.66; and 4.6% vs. 8%, p=0.153, respectively). The Charlson comorbidity index was the only significant risk factor for complications within 3-months (aOR 1.1), whereas mesalamine (5-aminosalicylic acid [5-ASA]) use was protective (aOR 0.6). An ulcerative colitis diagnosis was the sole risk factor for complication at 6-months (aOR 1.5). CDI did not significantly impact outcomes or interact with IBD type.</p><p><strong>Conclusions: </strong>In elderly IBD patients hospitalized for IBD flare and subsequently discharged, a concurrent CDI infection was not associated with post-discharge IBD-related complications or mortality up to 1-year.</p>","PeriodicalId":94074,"journal":{"name":"Journal of Crohn's & colitis","volume":" ","pages":""},"PeriodicalIF":0.0000,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Crohn's & colitis","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1093/ecco-jcc/jjae161","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
Abstract
Objectives: Elderly hospitalized patients with inflammatory bowel disease (IBD) flare and concurrent Clostridioides difficile infection (CDI) are considered at high risk of IBD-related complications. We aimed to evaluate the short, intermediate, and long-term post-discharge complications among these patients.
Methods: A retrospective multicenter cohort study assessing outcomes of elderly individuals (≥60 years) hospitalized for an IBD flare who were tested for CDI (either positive or negative) and discharged. The primary outcome was the 3-months post-discharge IBD-related complication rates defined as: steroid dependency, re-admissions (emergency department or hospitalization), IBD-related surgery, or mortality. We assessed post-discharge IBD-related complications within 6-months and mortality at 12-months among secondary outcomes. Risk factors for complication were assessed by multivariable logistic regression.
Results: In a cohort of 654 patients hospitalized for IBD (age 68.9 [interquartile range {IQR}]:63.9-75.2) years, 60.9% ulcerative colitis), 23.4% were CDI-positive. Post-discharge complication rates at 3 and 6-months, and 12-months mortality, did not differ significantly between CDI-positive and CDI-negative patients (32% vs. 33.1%, p=0.8; 40.5% vs. 42.5%, p=0.66; and 4.6% vs. 8%, p=0.153, respectively). The Charlson comorbidity index was the only significant risk factor for complications within 3-months (aOR 1.1), whereas mesalamine (5-aminosalicylic acid [5-ASA]) use was protective (aOR 0.6). An ulcerative colitis diagnosis was the sole risk factor for complication at 6-months (aOR 1.5). CDI did not significantly impact outcomes or interact with IBD type.
Conclusions: In elderly IBD patients hospitalized for IBD flare and subsequently discharged, a concurrent CDI infection was not associated with post-discharge IBD-related complications or mortality up to 1-year.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
