Morbidity and mortality in severely burned children with Clostridium difficile-associated diarrhea

Celeste Finnerty, David Herndon, Jong Lee, Noe A. Rodriguez, Iman H. Al-Haj, Paul Wurzer, Brendan R. Calhoun, Marc G. Jeschke

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Background Clostridium difficile is a key culprit underlying nosocomial infectious diarrhea. We investigated the effect of C difficile-associated diarrhea (CDAD) on morbidity and mortality in severely burned children and CDAD risk factors. Methods After review of 2,840 records, 288 pediatric burn patients were identified as having stool output of >10 mL•kg-1•min-1 for ≥2 successive days and had stool samples immunoassayed for toxins A and B. A case control analysis was performed by matching cases to controls via logistic regression and propensity scores so that age, admission time, and time of occurrence could be controlled; the endpoints were mortality and hospitalization time. Results Eighteen patients tested positive for C difficile toxins (median age, 4 years; mean total body surface area burned, 59%). In the CDAD group, unadjusted in-hospital mortality was 28% (odds ratio, 5.4; 95% CI, 1.7-16.7; P =.01). Hospitalization averaged 48 days in the CDAD group and 38 days in the non-CDAD group (P =.24). Duration of stay per percent total body surface area burned was greater in the CDAD group (0.82 ± 0.4 vs 0.60 ± 0.4; P =.03), as were prolonged bouts of diarrhea complicated by acidosis (13 ± 16 vs 4 ± 5 days; P

Original languageEnglish (US)
Pages (from-to)1631-1637
Number of pages7
JournalSurgery (United States)
Volume159
Issue number6
DOIs
StatePublished - Jun 1 2016

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Clostridium difficile
Diarrhea
Morbidity
Mortality
Body Surface Area
Hospitalization
Propensity Score
Hospital Mortality
Acidosis
Logistic Models
Odds Ratio
Pediatrics

ASJC Scopus subject areas

  • Surgery

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Morbidity and mortality in severely burned children with Clostridium difficile-associated diarrhea. / Finnerty, Celeste; Herndon, David; Lee, Jong; Rodriguez, Noe A.; Al-Haj, Iman H.; Wurzer, Paul; Calhoun, Brendan R.; Jeschke, Marc G.

In: Surgery (United States), Vol. 159, No. 6, 01.06.2016, p. 1631-1637.

Research output: Contribution to journalArticle

Finnerty, C, Herndon, D, Lee, J, Rodriguez, NA, Al-Haj, IH, Wurzer, P, Calhoun, BR & Jeschke, MG 2016, 'Morbidity and mortality in severely burned children with Clostridium difficile-associated diarrhea', Surgery (United States), vol. 159, no. 6, pp. 1631-1637. https://doi.org/10.1016/j.surg.2016.01.004
Finnerty, Celeste ; Herndon, David ; Lee, Jong ; Rodriguez, Noe A. ; Al-Haj, Iman H. ; Wurzer, Paul ; Calhoun, Brendan R. ; Jeschke, Marc G. / Morbidity and mortality in severely burned children with Clostridium difficile-associated diarrhea. In: Surgery (United States). 2016 ; Vol. 159, No. 6. pp. 1631-1637.
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N2 - Background Clostridium difficile is a key culprit underlying nosocomial infectious diarrhea. We investigated the effect of C difficile-associated diarrhea (CDAD) on morbidity and mortality in severely burned children and CDAD risk factors. Methods After review of 2,840 records, 288 pediatric burn patients were identified as having stool output of >10 mL•kg-1•min-1 for ≥2 successive days and had stool samples immunoassayed for toxins A and B. A case control analysis was performed by matching cases to controls via logistic regression and propensity scores so that age, admission time, and time of occurrence could be controlled; the endpoints were mortality and hospitalization time. Results Eighteen patients tested positive for C difficile toxins (median age, 4 years; mean total body surface area burned, 59%). In the CDAD group, unadjusted in-hospital mortality was 28% (odds ratio, 5.4; 95% CI, 1.7-16.7; P =.01). Hospitalization averaged 48 days in the CDAD group and 38 days in the non-CDAD group (P =.24). Duration of stay per percent total body surface area burned was greater in the CDAD group (0.82 ± 0.4 vs 0.60 ± 0.4; P =.03), as were prolonged bouts of diarrhea complicated by acidosis (13 ± 16 vs 4 ± 5 days; P

AB - Background Clostridium difficile is a key culprit underlying nosocomial infectious diarrhea. We investigated the effect of C difficile-associated diarrhea (CDAD) on morbidity and mortality in severely burned children and CDAD risk factors. Methods After review of 2,840 records, 288 pediatric burn patients were identified as having stool output of >10 mL•kg-1•min-1 for ≥2 successive days and had stool samples immunoassayed for toxins A and B. A case control analysis was performed by matching cases to controls via logistic regression and propensity scores so that age, admission time, and time of occurrence could be controlled; the endpoints were mortality and hospitalization time. Results Eighteen patients tested positive for C difficile toxins (median age, 4 years; mean total body surface area burned, 59%). In the CDAD group, unadjusted in-hospital mortality was 28% (odds ratio, 5.4; 95% CI, 1.7-16.7; P =.01). Hospitalization averaged 48 days in the CDAD group and 38 days in the non-CDAD group (P =.24). Duration of stay per percent total body surface area burned was greater in the CDAD group (0.82 ± 0.4 vs 0.60 ± 0.4; P =.03), as were prolonged bouts of diarrhea complicated by acidosis (13 ± 16 vs 4 ± 5 days; P

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