Ken Koon Wong1, Rebecca Lee2, Richard R Watkins3, Nairmeen Haller4. 1. Department of Internal Medicine, Akron General Medical Center, Akron, Ohio dap3ac3@gmail.com. 2. Department of Medicine, Northeast Ohio Medical University, Rootstown, Ohio. 3. Department of Internal Medicine, Akron General Medical Center, Akron, Ohio Department of Medicine, Northeast Ohio Medical University, Rootstown, Ohio Division of Infectious Disease, Akron General Medical Center, Akron, Ohio. 4. Department of Internal Medicine, Akron General Medical Center, Akron, Ohio Department of Medicine, Northeast Ohio Medical University, Rootstown, Ohio.
Abstract
BACKGROUND: Clostridium difficile infection (CDI) is one of the leading causes of hospital-acquired infections, creating a financial burden for the U.S. healthcare system. Reports suggest that vitamin D-deficient CDI patients incur higher healthcare-associated expenses and longer lengths of stay compared to nondeficient counterparts. The objective here was to evaluate the relationship between vitamin D level and CDI recurrence. MATERIALS AND METHODS: A retrospective chart review was conducted for 112 patients with vitamin D level drawn within 3 months of CDI diagnosis. Recurrence, severity of disease, 30-day mortality, and course of CDI were assessed. RESULTS: The vitamin D-deficient group included 56 patients, and the normal group included 56 patients. The mean age of vitamin D-deficient and -sufficient groups was 68 ± 15.7 and 71 ± 14.4 years, respectively. The mean 25(OH) D level in the deficient group was 11.7 ± 4.6 ng/mL, and it was 36.2 ± 16.2 ng/mL in the normal group. A longer course of diarrhea was apparent in the vitamin D-deficient group compared to the normal group: 6.1 days (95% confidence interval [CI], 4.9-7.2) vs 4.2 days (95% CI, 3.5-4.9; P = .01). Sepsis rate was 24% in vitamin D-deficient group and 13% in normal group (P = .03). There were no differences in CDI recurrence, length of stay, severity of illness, and mortality with respect to vitamin D status. CONCLUSION: There may be an association between course of diarrhea and increased rate of sepsis in vitamin D-deficient CDI patients.
BACKGROUND:Clostridium difficileinfection (CDI) is one of the leading causes of hospital-acquired infections, creating a financial burden for the U.S. healthcare system. Reports suggest that vitamin D-deficient CDI patients incur higher healthcare-associated expenses and longer lengths of stay compared to nondeficient counterparts. The objective here was to evaluate the relationship between vitamin D level and CDI recurrence. MATERIALS AND METHODS: A retrospective chart review was conducted for 112 patients with vitamin D level drawn within 3 months of CDI diagnosis. Recurrence, severity of disease, 30-day mortality, and course of CDI were assessed. RESULTS: The vitamin D-deficient group included 56 patients, and the normal group included 56 patients. The mean age of vitamin D-deficient and -sufficient groups was 68 ± 15.7 and 71 ± 14.4 years, respectively. The mean 25(OH) D level in the deficient group was 11.7 ± 4.6 ng/mL, and it was 36.2 ± 16.2 ng/mL in the normal group. A longer course of diarrhea was apparent in the vitamin D-deficient group compared to the normal group: 6.1 days (95% confidence interval [CI], 4.9-7.2) vs 4.2 days (95% CI, 3.5-4.9; P = .01). Sepsis rate was 24% in vitamin D-deficient group and 13% in normal group (P = .03). There were no differences in CDI recurrence, length of stay, severity of illness, and mortality with respect to vitamin D status. CONCLUSION: There may be an association between course of diarrhea and increased rate of sepsis in vitamin D-deficient CDI patients.
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