Post-Discharge Outcomes of Elderly Patients Hospitalized for Inflammatory Bowel Disease Flare Complicated by Clostridioides difficile Infection

被引：0

作者：

Goren, Idan ^{[1
,2
]}

Boldes, Ortal Fallek ^{[3
]}

Boldes, Tomer ^{[4
]}

Knyazev, Oleg ^{[5
,6
]}

Kagramanova, Anna ^{[5
,7
]}

Limdi, Jimmy K. ^{[8
,9
]}

Liu, Eleanor ^{[9
]}

Sethi-Arora, Karishma ^{[8
]}

Holvoet, Tom ^{[10
,11
]}

Eder, Piotr ^{[12
]}

Bezzio, Cristina ^{[13
,14
]}

Saibeni, Simone ^{[15
]}

Vernero, Marta ^{[15
,16
]}

Alimenti, Eleonora ^{[15
,17
]}

Chaparro, Maria ^{[18
,19
]}

Gisbert, Javier P. ^{[18
,19
]}

Orfanoudaki, Eleni ^{[20
]}

Koutroubakis, Ioannis E. ^{[20
]}

Pugliese, Daniela ^{[21
]}

Cuccia, Giuseppe ^{[22
]}

Suarez, Cristina Calvino ^{[23
]}

Ribaldone, Davide Giuseppe ^{[17
]}

Veisman, Ido ^{[24
,25
]}

Sharif, Kassem ^{[24
,25
]}

Aratari, Annalisa ^{[26
,27
]}

Papi, Claudio ^{[26
,27
]}

Mylonas, Iordanis ^{[26
,27
]}

Mantzaris, Gerassimos J. ^{[26
,27
]}

Truyens, Marie ^{[27
]}

Ortega, Triana Lobaton ^{[28
]}

Nancey, Stephane ^{[29
]}

Castiglione, Fabiana ^{[30
]}

Nardone, Olga Maria ^{[31
]}

Calabrese, Giulio ^{[31
]}

Karmiris, Konstantinos ^{[32
]}

Velegraki, Magdalini ^{[32
]}

Theodoropoulou, Angeliki ^{[32
]}

Shitrit, Ariella Bar-Gil ^{[33
]}

Lukas, Milan ^{[34
,35
]}

Vojtechova, Gabriela ^{[34
,35
]}

Ellul, Pierre ^{[36
]}

Bugeja, Luke ^{[36
]}

Savarino, Edoardo, V ^{[37
]}

Fischler, Tali Sharar ^{[1
]}

Dotan, Iris ^{[1
]}

Yanai, Henit ^{[1
]}

机构：

[1] Tel Aviv Univ, Fac Med & Hlth Sci, Rabin Med Ctr, Div Gastroenterol, Tel Aviv, Israel

[2] SUNY Upstate Med Univ, Div Gastroenterol, Syracuse, NY 13210 USA

[3] Tel Aviv Univ, Fac Med & Hlth Sci, Rabin Med Ctr, Dept Internal Med E, Tel Aviv, Israel

[4] Tel Aviv Univ, Fac Med & Hlth Sci, Meir Med Ctr, Dept Otolaryngol, Tel Aviv, Israel

[5] Moscow Clin Sci Ctr, Moscow, Russia

[6] Natl Med Res Ctr Coloproctol, Moscow, Russia

[7] Res Inst Hlth Org & Med Management, Moscow, Russia

[8] Northern Care Alliance Hosp NHS Fdn Trust, Div Gastroenterol, Manchester, England

[9] Univ Manchester, Fac Biol Med & Hlth, Manchester, England

[10] VITAZ, Dept Gastroenterol, St Niklaas, Belgium

[11] Univ Hosp Ghent, Dept Gastroenterol, Ghent, Belgium

[12] Poznan Univ Med Sci, Dept Gastroenterol Dietet & Internal Med, Poznan, Poland

[13] IRCCS Humanitas Res Hosp, IBD Ctr, Milan, Italy

[14] Humanitas Univ, Dept Biomed Sci, Milan, Italy

[15] ASST RHODENSE, Dept Gastroenterol, Rho, Italy

[16] Univ Turin, Dept Med Sci, Turin, Italy

[17] Univ Pavia, Dept Med Sci, Gastroenterol Unit, Pavia, Italy

[18] Univ Autonoma Madrid, Hosp Univ La Princesa, Dept Gastroenterol, Inst Invest Sanitaria Princesa IIS Princesa, Madrid, Spain

[19] Ctr Invest Biomed Red Enfermedades Hepat & Digest, Madrid, Spain

[20] Univ Hosp Heraklion, Dept Gastroenterol, Iraklion, Greece

[21] Fdn Policlin Univ A Gemelli IRCCS, Dipartimento Sci Med & Chirurg, CEMAD IBD UNIT Unita Operat Complessa Med Interna, Rome, Italy

[22] Univ Cattolica Sacro Cuore, Dipartimento Univ Med & Chirurg Traslaz, Rome, Italy

[23] Univ Hosp Santiago De Compostela, Dept Gastroenterol & Hepatol, La Coruna, Spain

[24] Tel Aviv Univ, Fac Med, Sheba Med Ctr, Dept Gastroenterol, Tel Aviv, Israel

[25] Dept Gastroenterol, Ramat Gan, Israel

[26] S Filippo Neri Hosp, Dept Gastroenterol, Gastroenterol, Rome, Italy

[27] Evangelismos Polyclin Gen Hosp, Dept Gastroenterol, Athens, Greece

[28] Univ Ghent, Dept Internal Med & Pediat, Ghent, Belgium

[29] Hosp Civils Lyon, South Lyon Univ Hosp, Dept Gastroenterol, Lyon, France

[30] Univ Naples Federico II, Dept Clin Med & Surg, Gastroenterol, Naples, Italy

[31] Univ Naples Federico II, Dept Publ Hlth, Gastroenterol, Naples, Italy

[32] Venizeleio Gen Hosp, Dept Gastroenterol, Iraklion, Greece

[33] Hebrew Univ Jerusalem, Digest Dis Inst, Shaare Zedek Med Ctr, IBD MOM Unit, Jerusalem, Israel

[34] Charles Univ Prague, Clin & Res Ctr Inflammatory Bowel Dis ISCARE, Prague, Czech Republic

[35] Charles Univ Prague, Fac Med 1, Prague, Czech Republic

[36] Mater Dei Hosp, Div Gastroenterol, Birkirkara, Malta

[37] Univ Padua, Dept Surg Oncol & Gastroenterol, Div Gastroenterol, Padua, Italy

来源：

JOURNAL OF CROHNS & COLITIS | 2024年

关键词：

Inflammatory bowel disease; Clostridioides difficile; elderly; hospitalization; outcomes; mortality; PATHOGEN; RELAPSE; BURDEN; COHORT; IMPACT; IBD;

D O I：

10.1093/ecco-jcc/jjae161

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

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-month 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 month and mortality at 12 month 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 (UC)}, 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 UC diagnosis was the sole risk factor for complication at 6 months (aOR 1.5). Clostridioides difficile infection 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.

引用

页数：9

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