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":"因艰难梭菌感染并发炎症性肠病发作而住院的老年患者出院后的预后。","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":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"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\":null,\"pages\":null},\"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}","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}
Post-Discharge Outcomes of Elderly Patients Hospitalized for Inflammatory Bowel Disease Flare Complicated by Clostridioides difficile Infection.
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.
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