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

Table 5 Discrimination performance of published guidelines for prolonged (> 9 days) length of ICU stay following C. difficile infections (CDI) among adult inpatients with CDI who survived the first 30 days following CDI (N = 307)^a

Variables	SHEA-IDSA (2010)^b				SHEA-IDSA (2018)^b				ESCMID (2014)^c
	Original (N = 239)		Imputed (N = 307)		Original (N = 283)		Imputed (N = 307)		Original (N = 143)		Imputed (N = 307)
	aOR (95% CI)	p-value	aOR (95% CI)	p-value	aOR (95% CI)	p-value	aOR (95% CI)	p-value	aOR (95% CI)	p-value	aOR (95% CI)	p-value
Age > 65 years old	–	–	–	–	–	–	–	–	1.25 (0.60, 2.60)	0.549	1.45 (0.84, 2.51)	0.182
WBC > 15,000 cells/mm³	1.96 (1.06, 3.64)	0.033	2.19 (1.25, 3.83)	0.006	2.26 (1.28, 3.99)	0.005	2.10 (1.20, 3.67)	0.009	1.80 (0.84, 3.85)	0.129	2.11 (1.20, 3.70)	0.010
Rise in SCr ≥1.5-fold	1.31 (0.69, 2.49)	0.403	1.30 (0.70, 2.40)	0.411	–	–	–	–	–	–	–	–
SCr ≥1.5045 mg/dL	–	–	–	–	1.91 (1.10, 3.31)	0.022	1.84 (1.07, 3.16)	0.026	–	–	–	–
Rise in SCr ≥1.5-fold or ≥ 1.5045 mg/dL	–	–	–	–	–	–	–	–	2.38 (1.08, 5.23)	0.031	1.74 (0.98, 3.09)	0.057
Albumin < 3 g/dL	–	–	–	–	–	–	–	–	1.74 (0.72, 4.17)	0.219	1.29 (0.58, 2.85)	0.529
C statistic (95% CI)	0.591 (0.513, 0.670)		0.600 (0.527, 0.673)^d		0.643 (0.572, 0.714)		0.634 (0.564, 0.704)^d		0.657 (0.561, 0.754)		0.645 (0.573, 0.718)^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 logistic regression models and evaluated the discrimination performance of these models using conventional 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 (c statistic = 0.737; 95% CI = 0.671, 0.804).

ISSN: 2047-2994