Development of a risk prediction model for hospital-onset Clostridium difficile infection in patients receiving systemic antibiotics

Tilton, Carrie; Johnson, Steven W.

doi:10.1016/j.ajic.2018.08.021

Cited by 16 publications

(17 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A major strength of the developed model is that all variables included in the model are readily available in clinical practice. The performance of the model was comparable to the required performance of models for clinical utility 13,14 …”

Section: Discussionmentioning

confidence: 88%

Development of Risk Prediction Model for Grade 2 or Higher Hypocalcemia in Patients With Bone Metastasis Treated With Denosumab Plus Cholecalciferol (Vitamin D₃)/Calcium Supplement

Ikegami

Hashiguchi

Kizaki

et al. 2022

The Journal of Clinical Pharma

View full text Add to dashboard Cite

Denosumab‐induced hypocalcemia is sometimes severe, and although a natural vitamin D/calcium combination is used to prevent hypocalcemia, some patients rapidly develop severe hypocalcemia even under supplementation. It is clinically important to predict this risk. This study aimed to develop a risk prediction model for grade ≥2 hypocalcemia within 28 days after the first denosumab dose under natural vitamin D/calcium supplementation. Using a large database containing multicenter practice data, 2399 patients with bone metastasis who were treated with denosumab between June 2013 and May 2020 were retrospectively analyzed. Background factors in patients who developed grade ≥2 hypocalcemia within 28 days after the first denosumab dose and those who did not were compared by univariate analysis. Multivariate analysis was conducted to develop a risk prediction model. The model was evaluated for discriminant performance (receiver operating characteristic–area under the curve, sensitivity, specificity) and predictive performance (calibration slope). A total of 124 patients in the hypocalcemia group and 1191 patients in the nonhypocalcemia group were extracted. A risk prediction model consisting of sex, calcium, albumin, alkaline phosphatase, osteoporosis, breast cancer, gastric cancer, proton pump inhibitor combination, and pretreatment with zoledronic acid was developed. The receiver operating characteristic–area under the curve was 0.87. Sensitivity and specificity were 83% and 81%, respectively, and the calibration slope indicated acceptable agreement between observed and predicted risk. This model appears to be useful to predict the risk of denosumab‐induced hypocalcemia and thus should be helpful for risk management of denosumab treatment in patients with bone metastases.

show abstract

Section: Discussionmentioning

confidence: 88%

Development of Risk Prediction Model for Grade 2 or Higher Hypocalcemia in Patients With Bone Metastasis Treated With Denosumab Plus Cholecalciferol (Vitamin D₃)/Calcium Supplement

Ikegami

Hashiguchi

Kizaki

et al. 2022

The Journal of Clinical Pharma

View full text Add to dashboard Cite

show abstract

“…Recent hospitalization, use of corticosteroids and proton pump inhibitors were related to the increased risk of CDI in patients with IBD in this study. Similarly, recent hospitalization has been identified as a risk factor for CDI in other studies 23,37 . Hospitalization may increase exposure to C. difficile spores, as well as the likelihood of medication.…”

Section: Discussionmentioning

confidence: 85%

“…Similarly, recent hospitalization has been identified as a risk factor for CDI in other studies. 23 , 37 Hospitalization may increase exposure to C. difficile spores, as well as the likelihood of medication. Corticosteroids are effective for the induction of rapid remission of IBD symptoms; however, long‐term use of these drugs does not provide complete relief and may produce many adverse effects, including a risk of increased mortality.…”

Section: Discussionmentioning

confidence: 99%

Molecular epidemiology and clinical characteristics of Clostridioides difficile infection in patients with inflammatory bowel disease from a teaching hospital

Liao

Jian

et al. 2022

Clinical Laboratory Analysis

View full text Add to dashboard Cite

Background Clostridioides difficile infection (CDI) in patients with inflammatory bowel disease (IBD) is of increasing concern. This study aimed to investigate the molecular epidemiology and antimicrobial susceptibilities of toxigenic C. difficile isolated from IBD patients and to evaluate the risk factors for CDI in IBD population. Methods Loose or watery stools from IBD patients were tested for glutamate dehydrogenase, C. difficile toxins A&B and anaerobic culture. Toxigenic C. difficile isolates were characterized by multi‐locus sequence typing, ribotyping and antimicrobial susceptibility testing. Results The prevalence of CDI in IBD patients was 13.6% (43/317). The dominant sequence types (STs) were ST35 (20.9%), ST2 (18.6%) and ST37 (16.3%). The most common ribotypes (RTs) were RT 017 (18.6%), RT 012 (14.0%), and RT 220 (14.0%), whereas RT 027 and RT 078 were not detected in this study. All the isolates were susceptible to vancomycin and metronidazole. The multidrug resistance rate of C. difficile RT 017 was higher (p < 0.01) than that of other RT strains. Recent hospitalization, use of corticosteroids and proton pump inhibitors were related to increased risk of CDI in IBD patients; of these, recent hospitalization and proton pump inhibitors use were independent risk factors. Conclusion Patients with IBD have a relatively high incidence rate of CDI. C. difficile RT 017 is most frequently isolated from IBD patients in this region and warrants more attention to its high resistance rate. Clinicians should pay greater attention to CDI testing in IBD patients with diarrhea to ensure early diagnosis and initiation of effective treatment.

show abstract

“…Two groups developed an index model to be validated on external data in a separate, later study (one of these proposed an additional, updated model). [13][14][15][16] Two studies reported 2 risk-prediction models each; thus, our review assessed a total of 12 risk-prediction models from 11 articles. 17,18 We used 11 as the denominator when reference was made to studies and 12 when reference was made to prediction models.…”

Section: Study Selectionmentioning

confidence: 99%

Diagnostic prediction models to identify patients at risk for healthcare-facility–onset Clostridioides difficile: A systematic review of methodology and reporting

Patterson,

Fajnzylber,

Nero

et al. 2023

Infect. Control Hosp. Epidemiol.

View full text Add to dashboard Cite

Objective: To systematically review the methodology, performance, and generalizability of diagnostic models for predicting the risk of healthcare-facility–onset (HO) Clostridioides difficile infection (CDI) in adult hospital inpatients (aged ≥18 years). Background: CDI is the most common cause of healthcare-associated diarrhea. Prediction models that identify inpatients at risk of HO-CDI have been published; however, the quality and utility of these models remain uncertain. Methods: Two independent reviewers evaluated articles describing the development and/or validation of multivariable HO-CDI diagnostic models in an inpatient setting. All publication dates, languages, and study designs were considered. Model details (eg, sample size and source, outcome, and performance) were extracted from the selected studies based on the CHARMS checklist. The risk of bias was further assessed using PROBAST. Results: Of the 3,030 records evaluated, 11 were eligible for final analysis, which described 12 diagnostic models. Most studies clearly identified the predictors and outcomes but did not report how missing data were handled. The most frequent predictors across all models were advanced age, receipt of high-risk antibiotics, history of hospitalization, and history of CDI. All studies reported the area under the receiver operating characteristic curve (AUROC) as a measure of discriminatory ability. However, only 3 studies reported the model calibration results, and only 2 studies were externally validated. All of the studies had a high risk of bias. Conclusion: The studies varied in their ability to predict the risk of HO-CDI. Future models will benefit from the validation on a prospective external cohort to maximize external validity.

show abstract

Development of a risk prediction model for hospital-onset Clostridium difficile infection in patients receiving systemic antibiotics

Cited by 16 publications

References 15 publications

Development of Risk Prediction Model for Grade 2 or Higher Hypocalcemia in Patients With Bone Metastasis Treated With Denosumab Plus Cholecalciferol (Vitamin D₃)/Calcium Supplement

Development of Risk Prediction Model for Grade 2 or Higher Hypocalcemia in Patients With Bone Metastasis Treated With Denosumab Plus Cholecalciferol (Vitamin D₃)/Calcium Supplement

Molecular epidemiology and clinical characteristics of Clostridioides difficile infection in patients with inflammatory bowel disease from a teaching hospital

Diagnostic prediction models to identify patients at risk for healthcare-facility–onset Clostridioides difficile: A systematic review of methodology and reporting

Contact Info

Product

Resources

About

Development of a risk prediction model for hospital-onset Clostridium difficile infection in patients receiving systemic antibiotics

Cited by 16 publications

References 15 publications

Development of Risk Prediction Model for Grade 2 or Higher Hypocalcemia in Patients With Bone Metastasis Treated With Denosumab Plus Cholecalciferol (Vitamin D3)/Calcium Supplement

Development of Risk Prediction Model for Grade 2 or Higher Hypocalcemia in Patients With Bone Metastasis Treated With Denosumab Plus Cholecalciferol (Vitamin D3)/Calcium Supplement

Molecular epidemiology and clinical characteristics of Clostridioides difficile infection in patients with inflammatory bowel disease from a teaching hospital

Diagnostic prediction models to identify patients at risk for healthcare-facility–onset Clostridioides difficile: A systematic review of methodology and reporting

Contact Info

Product

Resources

About

Development of Risk Prediction Model for Grade 2 or Higher Hypocalcemia in Patients With Bone Metastasis Treated With Denosumab Plus Cholecalciferol (Vitamin D₃)/Calcium Supplement

Development of Risk Prediction Model for Grade 2 or Higher Hypocalcemia in Patients With Bone Metastasis Treated With Denosumab Plus Cholecalciferol (Vitamin D₃)/Calcium Supplement