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Derivation and validation of a simple, accurate and robust prediction rule for risk of mortality in patients with Clostridium difficile infection.


ABSTRACT:

Background

Clostridium difficile infection poses a significant healthcare burden. However, the derivation of a simple, evidence based prediction rule to assist patient management has not yet been described.

Method

Univariate, multivariate and decision tree procedures were used to deduce a prediction rule from over 186 variables; retrospectively collated from clinical data for 213 patients. The resulting prediction rule was validated on independent data from a cohort of 158 patients described by Bhangu et al. (Colorectal Disease, 12(3):241-246, 2010).

Results

Serum albumin levels (g/L) (P?=?0.001), respiratory rate (resps /min) (P?=?0.002), C-reactive protein (mg/L) (P?=?0.034) and white cell count (mcL) (P?=?0.049) were predictors of all-cause mortality. Threshold levels of serum albumin???24.5 g/L, C- reactive protein >228 mg/L, respiratory rate >17 resps/min and white cell count >12?×?10(3) mcL were associated with an increased risk of all-cause mortality. A simple four variable prediction rule was devised based on these threshold levels and when tested on the initial data, yield an area under the curve score of 0.754 (P?ConclusionsFour easily measurable clinical variables can be used to assess the risk of mortality of patients with Clostridium difficile infection and remains robust with respect to independent data.

SUBMITTER: Butt E 

PROVIDER: S-EPMC3733667 | biostudies-literature | 2013 Jul

REPOSITORIES: biostudies-literature

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Publications

Derivation and validation of a simple, accurate and robust prediction rule for risk of mortality in patients with Clostridium difficile infection.

Butt Emma E   Foster Jane A H JA   Keedwell Edward E   Bell Julia E A JE   Titball Richard W RW   Bhangu Aneel A   Michell Stephen L SL   Sheridan Ray R  

BMC infectious diseases 20130712


<h4>Background</h4>Clostridium difficile infection poses a significant healthcare burden. However, the derivation of a simple, evidence based prediction rule to assist patient management has not yet been described.<h4>Method</h4>Univariate, multivariate and decision tree procedures were used to deduce a prediction rule from over 186 variables; retrospectively collated from clinical data for 213 patients. The resulting prediction rule was validated on independent data from a cohort of 158 patient  ...[more]

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