Karn Wijarnpreecha1, Suthanya Sornprom2, Charat Thongprayoon3, Parkpoom Phatharacharukul4, Wisit Cheungpasitporn5, Kiran Nakkala2. 1. Department of Internal Medicine, Bassett Medical Center, Cooperstown, NY, USA. Electronic address: dr.karn.wi@gmail.com. 2. Department of Internal Medicine, Bassett Medical Center, Cooperstown, NY, USA. 3. Department of Internal Medicine, Bassett Medical Center, Cooperstown, NY, USA; Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN, USA. 4. Department of Internal Medicine, University of Minnesota, Minneapolis, MN, USA. 5. Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN, USA.
Abstract
BACKGROUND/ OBJECTIVES: Clostridium difficile-associated diarrhea (CDAD) is a major concern of public health worldwide. The risk of CDAD in patients with nasogastric tube (NGT) insertion is controversial. The aim of this study was to assess the risk of incidence of CDAD in patients with NGT insertion. METHODS: A literature search was performed using MEDLINE, EMBASE, and Cochrane Database of Systematic Reviews from inception through August 2015. Studies that reported relative risks, odds ratios, or hazard ratios comparing the risk of CDAD in patients with NGT insertion versus those who did not were included. Pooled risk ratios (RR) and 95% confidence interval (CI) were calculated using a random-effect, generic inverse variance method. RESULTS: Eleven observational studies were included in our analysis to assess the association between NGT insertion and risk of CDAD. The pooled RR of CDAD in patients with NGT insertion was 1.87 (95% CI, 1.06-3.28, I(2)=73). When meta-analysis was limited only to cohort and case-control studies, the pooled RR of CDAD was 1.99 (95% CI, 1.05-3.77, I(2)=76). CONCLUSIONS: Our study demonstrated a statistically significant association between NGT insertion and risk of CDAD. This finding may impact clinical management and primary prevention of CDAD.
BACKGROUND/ OBJECTIVES:Clostridium difficile-associated diarrhea (CDAD) is a major concern of public health worldwide. The risk of CDAD in patients with nasogastric tube (NGT) insertion is controversial. The aim of this study was to assess the risk of incidence of CDAD in patients with NGT insertion. METHODS: A literature search was performed using MEDLINE, EMBASE, and Cochrane Database of Systematic Reviews from inception through August 2015. Studies that reported relative risks, odds ratios, or hazard ratios comparing the risk of CDAD in patients with NGT insertion versus those who did not were included. Pooled risk ratios (RR) and 95% confidence interval (CI) were calculated using a random-effect, generic inverse variance method. RESULTS: Eleven observational studies were included in our analysis to assess the association between NGT insertion and risk of CDAD. The pooled RR of CDAD in patients with NGT insertion was 1.87 (95% CI, 1.06-3.28, I(2)=73). When meta-analysis was limited only to cohort and case-control studies, the pooled RR of CDAD was 1.99 (95% CI, 1.05-3.77, I(2)=76). CONCLUSIONS: Our study demonstrated a statistically significant association between NGT insertion and risk of CDAD. This finding may impact clinical management and primary prevention of CDAD.
Authors: Clara Lina Salazar; Catalina Reyes; Santiago Atehortua; Patricia Sierra; Margarita María Correa; Daniel Paredes-Sabja; Emma Best; Warren N Fawley; Mark Wilcox; Ángel González Journal: PLoS One Date: 2017-09-13 Impact factor: 3.240