Risk prediction for 30-day mortality among patients with Clostridium difficile infections: a retrospective cohort study

Table 2 Discrimination performance of published guidelines for 30-day mortality among adult inpatients with C. difficile infections^a

Variables	SHEA-IDSA (2010)^b				SHEA-IDSA (2018)^b				ESCMID (2014)^c
	Original (N = 322)		Imputed (N = 401)		Original (N = 374)		Imputed (N = 401)		Original (N = 165)		Imputed (N = 401)
	aHR (95% CI)	p-value	aHR (95% CI)	p-value	aHR (95% CI)	p-value	aHR (95% CI)	p-value	aHR (95% CI)	p-value	aHR (95% CI)	p-value
Age > 65 years old	–	–	–	–	–	–	–	–	1.44 (0.84, 2.47)	0.185	1.41 (0.91, 2.17)	0.124
WBC > 15,000 cells/mm³	1.44 (0.92, 2.24)	0.110	1.43 (0.92, 2.24)	0.113	1.72 (1.13, 2.61)	0.012	1.69 (1.11, 2.56)	0.013	1.91 (1.12, 3.27)	0.018	1.51 (1.00, 2.29)	0.053
Rise in SCr ≥1.5-fold	2.55 (1.64, 3.98)	< 0.0001	2.58 (1.65, 4.03)	< 0.0001	–	–	–	–	–	–	–	–
SCr ≥1.5045 mg/dL	–	–	–	–	1.27 (0.84, 1.93)	0.265	1.35 (0.89, 2.04)	0.157	–	–	–	–
Rise in SCr ≥1.5-fold or ≥ 1.5045 mg/dL	–	–	–	–	–	–	–	–	1.40 (0.77, 2.54)	0.268	2.23 (1.37, 3.61)	0.001
Albumin < 3 g/dL	–	–	–	–	–	–	–	–	1.93 (0.91, 4.08)	0.085	1.60 (0.83, 3.10)	0.159
c statistic (95% CI)	0.644 (0.587, 0.701)		0.645 (0.588, 0.702)^d		0.587 (0.533, 0.641)		0.591 (0.537, 0.644)^d		0.640 (0.571, 0.709)		0.650 (0.594, 0.706)^d

Abbreviations: aHR adjusted hazard ratio, CDI C. difficile infections, CI confidence interval, SCr serum creatinine, WBC white blood cell count
^aWe included the variables in separate Cox proportional hazard models and evaluated the discrimination performance of these models using Harrell’s c statistic.
^bThe Society of Hospital Epidemiology of America (SHEA) and the Infectious Disease Society of America (IDSA) jointly published the clinical practice guidelines for CDI in 2010 and updated in 2018 (Cohen 2010; McDonald 2018).
^cThe European Society of Clinical Microbiology and Infectious Diseases (ESCMID) published the treatment guideline for CDI in 2014 (Debast 2014).
^dThe discrimination performance of these models was significantly lower than that of our prediction model (Harrell’s c statistic = 0.727; 95% CI = 0.672, 0.782).

ISSN: 2047-2994