Predictors of recurrent CDI among patients with diagnosis of CDI
| Covariate | Recurrence type; adjusted HR (95% CI)* | |
|---|---|---|
| First recurrence† | Second recurrence‡ | |
| Age, yr (Ref: 18–69 yr) | ||
| 70–79 | 1.51 (1.27 to 1.79) | 1.61 (1.14 to 2.28) |
| ≥ 80 | 2.01 (1.72 to 2.34) | 2.76 (2.06 to 3.70) |
| Female sex (v. male) | 1.16 (1.02 to 1.32) | 0.99 (0.78 to 1.25) |
| SEFI (Ref: richer v. poorer) | 0.92 (0.82 to 1.04) | 0.98 (0.78 to 1.23) |
| CCI (Ref: 0)§ | ||
| 1 | 1.23 (1.02 to 1.47) | 0.83 (0.57 to 1.20) |
| 2 | 1.17 (0.96 to 1.42) | 1.35 (0.96 to 1.91) |
| ≥ 3 | 1.18 (0.97 to 1.45) | 1.23 (0.84 to 1.78) |
| Diabetes (v. none) | 1.06 (0.91 to 1.23) | 1.00 (0.76 to 1.31) |
| Renal disease (v. none) | 1.07 (0.89 to 1.30) | 1.17 (0.84 to 1.63) |
| IBD (v. none) | 1.13 (0.79 to 1.63) | 0.81 (0.36 to 1.83) |
| Ambulatory care visits in prior year (v. most) | ||
| Least | 1.17 (0.96 to 1.43) | 1.93 (1.20 to 3.11) |
| Quartile 2 | 1.20 (0.97 to 1.48) | 1.92 (1.21 to 3.05) |
| Quartile 3 | 1.10 (0.88 to 1.38) | 2.12 (1.37 to 3.27) |
| CDI subtype (v. community-associated) | ||
| HCF-onset HCF-associated¶ | 1.20 (1.02 to 1.42) | 1.28 (0.91 to 1.79) |
| Community-onset HCF-associated | 1.25 (1.03 to 1.53) | 1.51 (1.03 to 2.21) |
| Indeterminate | 1.18 (0.93 to 1.50) | 1.34 (0.86 to 2.11) |
Note: CDI = Clostridioides difficile infection, CCI = Charlson Comorbidity Index, CI = confidence interval, HCF = health care facility, HR = hazard ratio, IBD = inflammatory bowel disease, Ref = Reference, SEFI = Socioeconomic Factor Index.
↵* HRs were adjusted for all factors listed in table.
↵† For the first recurrence analysis, we included 5795 incident CDIs with > 14 days follow-up. There were 1021 recurrences (events) and 421 deaths (competing events).
↵‡ For the second recurrence analysis, we included 5558 incident CDIs with > 28 day follow-up. There were 295 recurrences (events) and 500 deaths (competing events).
↵§ Renal disease and diabetes omitted from CCI calculation.
↵¶ In the subgroup analysis of those with HCF-onset HCF-associated CDI (n = 2338), longer hospitalization (> 14 days) before CDI onset was associated with increased risk of both first CDI recurrence (n = 477; HR 1.70 [95% CI 1.40 to 2.06]) as well as the second CDI recurrence (n = 142; HR 1.76 [95% CI 1.23 to 2.52]).