Novel risk factors and outcomes in inflammatory bowel disease patients with infection
Background: Patients with inflammatory bowel disease (IBD) are at significantly increased risk for Clostridioides difficile infection (CDI) with an increased risk of adverse outcomes including increased in-hospital mortality, IBD treatment failure, re-hospitalization, and high CDI recurrence rates....
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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SAGE Publishing
2021-03-01
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| Series: | Therapeutic Advances in Gastroenterology |
| Online Access: | https://doi.org/10.1177/1756284821997792 |
| _version_ | 1818676907547295744 |
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| author | Elida Voth Dipesh Solanky Edward V. Loftus Darrell S. Pardi Sahil Khanna |
| author_facet | Elida Voth Dipesh Solanky Edward V. Loftus Darrell S. Pardi Sahil Khanna |
| author_sort | Elida Voth |
| collection | DOAJ |
| description | Background: Patients with inflammatory bowel disease (IBD) are at significantly increased risk for Clostridioides difficile infection (CDI) with an increased risk of adverse outcomes including increased in-hospital mortality, IBD treatment failure, re-hospitalization, and high CDI recurrence rates. The existing literature on predictors of these adverse outcomes is limited. We evaluated four potentially modifiable novel risk factors [body mass index (BMI), statin use, opioid use, and antidepressant use] on CDI risk and adverse outcomes in these patients. Methods: Using a retrospective design, variables were abstracted from records for patients with IBD and CDI from 2008 to 2013. Statistical analysis comprised descriptive statistics and univariate and multivariate logistic regression analyses. Results: There were 137 patients with IBD and CDI included in this study. On multivariate analysis controlling for age, 43% of patients in the overweight BMI category had severe or severe, complicated CDI, compared with 22% of patients in the underweight/normal BMI [odds ratio (OR) 2.85, p = 0.02] and 19% in the obese category (OR 3.95, p = 0.04). Statin use was associated with severe or severe, complicated CDI when controlling for age and BMI (OR 5.66, p = 0.01). There was no association between statin use and IBD exacerbations following CDI. Opioid and antidepressant use were not associated with disease severity or frequency of IBD exacerbations following CDI. Conclusions: An overweight BMI and statin use were associated with severe or severe, complicated CDI in IBD patients. Further studies are needed to better understand how these factors impact management of patients with IBD to improve clinical outcomes and potentially reduce the risk of complications from CDI. |
| first_indexed | 2024-12-17T08:50:56Z |
| format | Article |
| id | doaj.art-c6ecd6d49db74597885d94c49527ce87 |
| institution | Directory Open Access Journal |
| issn | 1756-2848 |
| language | English |
| last_indexed | 2024-12-17T08:50:56Z |
| publishDate | 2021-03-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Therapeutic Advances in Gastroenterology |
| spelling | doaj.art-c6ecd6d49db74597885d94c49527ce872022-12-21T21:56:05ZengSAGE PublishingTherapeutic Advances in Gastroenterology1756-28482021-03-011410.1177/1756284821997792Novel risk factors and outcomes in inflammatory bowel disease patients with infectionElida VothDipesh SolankyEdward V. LoftusDarrell S. PardiSahil KhannaBackground: Patients with inflammatory bowel disease (IBD) are at significantly increased risk for Clostridioides difficile infection (CDI) with an increased risk of adverse outcomes including increased in-hospital mortality, IBD treatment failure, re-hospitalization, and high CDI recurrence rates. The existing literature on predictors of these adverse outcomes is limited. We evaluated four potentially modifiable novel risk factors [body mass index (BMI), statin use, opioid use, and antidepressant use] on CDI risk and adverse outcomes in these patients. Methods: Using a retrospective design, variables were abstracted from records for patients with IBD and CDI from 2008 to 2013. Statistical analysis comprised descriptive statistics and univariate and multivariate logistic regression analyses. Results: There were 137 patients with IBD and CDI included in this study. On multivariate analysis controlling for age, 43% of patients in the overweight BMI category had severe or severe, complicated CDI, compared with 22% of patients in the underweight/normal BMI [odds ratio (OR) 2.85, p = 0.02] and 19% in the obese category (OR 3.95, p = 0.04). Statin use was associated with severe or severe, complicated CDI when controlling for age and BMI (OR 5.66, p = 0.01). There was no association between statin use and IBD exacerbations following CDI. Opioid and antidepressant use were not associated with disease severity or frequency of IBD exacerbations following CDI. Conclusions: An overweight BMI and statin use were associated with severe or severe, complicated CDI in IBD patients. Further studies are needed to better understand how these factors impact management of patients with IBD to improve clinical outcomes and potentially reduce the risk of complications from CDI.https://doi.org/10.1177/1756284821997792 |
| spellingShingle | Elida Voth Dipesh Solanky Edward V. Loftus Darrell S. Pardi Sahil Khanna Novel risk factors and outcomes in inflammatory bowel disease patients with infection Therapeutic Advances in Gastroenterology |
| title | Novel risk factors and outcomes in inflammatory bowel disease patients with infection |
| title_full | Novel risk factors and outcomes in inflammatory bowel disease patients with infection |
| title_fullStr | Novel risk factors and outcomes in inflammatory bowel disease patients with infection |
| title_full_unstemmed | Novel risk factors and outcomes in inflammatory bowel disease patients with infection |
| title_short | Novel risk factors and outcomes in inflammatory bowel disease patients with infection |
| title_sort | novel risk factors and outcomes in inflammatory bowel disease patients with infection |
| url | https://doi.org/10.1177/1756284821997792 |
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