Chandra et al reported a prediction scale for identifying a patient with hospital-onset Clostridium difficile infection. This can help to identify a patient who may require an additional evaluation. The authors are from Greater Baltimore Medical Center in Baltimore.
Patient selection: hospitalized adults (> 18 years)
Parameters:
(1) unformed stool
(2) hospital length of stay
(3) age of the patient in years
(4) residence
(5) antibiotic use
(6) serum albumin in g/L
|
Parameter |
Finding |
Points |
|
unformed stool |
none |
0 |
|
|
new-onset |
5 |
|
|
chronic |
0 |
|
hospital stay |
<= 7 days |
0 |
|
|
> 7 days |
4 |
|
age in years |
<= 65 years |
0 |
|
|
> 65 years |
3 |
|
Residence |
long-term care facility |
2 |
|
|
other |
0 |
|
antibiotic use |
none |
0 |
|
|
high risk |
1 |
|
|
low risk |
0 |
|
serum albumin |
>= 30 g/L |
0 |
|
|
< 30 g/L |
1 |
total score =
= SUM(points for all 6 parameters)
Interpretation:
• minimum score: 0
• maximum score: 16
• A score >= 9 indicated a patient at increased risk for hospital-onset Clostridium difficile disease.
Performance:
• The sensitivity at the cutoff was 94% with specificity of 80%.
• The reported area under the ROC curve was 0.93.
Specialty: Infectious Diseases, Gastroenterology
