Cargando…
Evaluation of a risk score to predict future Clostridium difficile disease using UK primary care and hospital data in Clinical Practice Research Datalink
We evaluated the applicability of a Clostridium difficile infection (CDI) risk index developed for patients at hospital discharge to identify persons at high-risk of CDI in a primary care population. This retrospective observational study used data from the UK Clinical Practice Research Datalink, li...
Autores principales: | , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Taylor & Francis
2019
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6816380/ https://www.ncbi.nlm.nih.gov/pubmed/30945972 http://dx.doi.org/10.1080/21645515.2019.1589288 |
_version_ | 1783463359830556672 |
---|---|
author | Marley, Clare El Hahi, Yassine Ferreira, Germano Woods, Laura Ramirez Villaescusa, Ana |
author_facet | Marley, Clare El Hahi, Yassine Ferreira, Germano Woods, Laura Ramirez Villaescusa, Ana |
author_sort | Marley, Clare |
collection | PubMed |
description | We evaluated the applicability of a Clostridium difficile infection (CDI) risk index developed for patients at hospital discharge to identify persons at high-risk of CDI in a primary care population. This retrospective observational study used data from the UK Clinical Practice Research Datalink, linked with Hospital Episodes Statistics. The risk index was based on the following patient characteristics: age, previous hospitalizations, days in hospital, and prior antibiotics use. Individual risk scores were calculated by summing points assigned to pre-defined categories for each characteristic. We assessed the association of risk factors with CDI by multivariate logistic regression. The estimated CDI incidence rate was 4/10,000 and 2/10,000 person-years in 2008 and 2012, respectively. On an index with a maximal risk of 19, a cut-off for high risk of ≥7 had sensitivity, specificity and positive predictive values of 80%, 87% and 12%, respectively. A high-risk person had a ~ 35% higher risk of CDI than a low-risk person. Multivariate risk factor analysis indicated a need to reconsider the relative risk scores. The CDI risk index can be applied to the UK primary care population and help identify study populations for vaccine development studies. Reassessing the relative weights assigned to risk factors could improve the index performance in this setting. |
format | Online Article Text |
id | pubmed-6816380 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Taylor & Francis |
record_format | MEDLINE/PubMed |
spelling | pubmed-68163802019-11-05 Evaluation of a risk score to predict future Clostridium difficile disease using UK primary care and hospital data in Clinical Practice Research Datalink Marley, Clare El Hahi, Yassine Ferreira, Germano Woods, Laura Ramirez Villaescusa, Ana Hum Vaccin Immunother Research Paper We evaluated the applicability of a Clostridium difficile infection (CDI) risk index developed for patients at hospital discharge to identify persons at high-risk of CDI in a primary care population. This retrospective observational study used data from the UK Clinical Practice Research Datalink, linked with Hospital Episodes Statistics. The risk index was based on the following patient characteristics: age, previous hospitalizations, days in hospital, and prior antibiotics use. Individual risk scores were calculated by summing points assigned to pre-defined categories for each characteristic. We assessed the association of risk factors with CDI by multivariate logistic regression. The estimated CDI incidence rate was 4/10,000 and 2/10,000 person-years in 2008 and 2012, respectively. On an index with a maximal risk of 19, a cut-off for high risk of ≥7 had sensitivity, specificity and positive predictive values of 80%, 87% and 12%, respectively. A high-risk person had a ~ 35% higher risk of CDI than a low-risk person. Multivariate risk factor analysis indicated a need to reconsider the relative risk scores. The CDI risk index can be applied to the UK primary care population and help identify study populations for vaccine development studies. Reassessing the relative weights assigned to risk factors could improve the index performance in this setting. Taylor & Francis 2019-04-04 /pmc/articles/PMC6816380/ /pubmed/30945972 http://dx.doi.org/10.1080/21645515.2019.1589288 Text en © 2019 GlaxoSmithKline Biologicals SA. Published with license by Taylor & Francis Group, LLC. http://creativecommons.org/licenses/by/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Research Paper Marley, Clare El Hahi, Yassine Ferreira, Germano Woods, Laura Ramirez Villaescusa, Ana Evaluation of a risk score to predict future Clostridium difficile disease using UK primary care and hospital data in Clinical Practice Research Datalink |
title | Evaluation of a risk score to predict future Clostridium difficile disease using UK primary care and hospital data in Clinical Practice Research Datalink |
title_full | Evaluation of a risk score to predict future Clostridium difficile disease using UK primary care and hospital data in Clinical Practice Research Datalink |
title_fullStr | Evaluation of a risk score to predict future Clostridium difficile disease using UK primary care and hospital data in Clinical Practice Research Datalink |
title_full_unstemmed | Evaluation of a risk score to predict future Clostridium difficile disease using UK primary care and hospital data in Clinical Practice Research Datalink |
title_short | Evaluation of a risk score to predict future Clostridium difficile disease using UK primary care and hospital data in Clinical Practice Research Datalink |
title_sort | evaluation of a risk score to predict future clostridium difficile disease using uk primary care and hospital data in clinical practice research datalink |
topic | Research Paper |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6816380/ https://www.ncbi.nlm.nih.gov/pubmed/30945972 http://dx.doi.org/10.1080/21645515.2019.1589288 |
work_keys_str_mv | AT marleyclare evaluationofariskscoretopredictfutureclostridiumdifficilediseaseusingukprimarycareandhospitaldatainclinicalpracticeresearchdatalink AT elhahiyassine evaluationofariskscoretopredictfutureclostridiumdifficilediseaseusingukprimarycareandhospitaldatainclinicalpracticeresearchdatalink AT ferreiragermano evaluationofariskscoretopredictfutureclostridiumdifficilediseaseusingukprimarycareandhospitaldatainclinicalpracticeresearchdatalink AT woodslaura evaluationofariskscoretopredictfutureclostridiumdifficilediseaseusingukprimarycareandhospitaldatainclinicalpracticeresearchdatalink AT ramirezvillaescusaana evaluationofariskscoretopredictfutureclostridiumdifficilediseaseusingukprimarycareandhospitaldatainclinicalpracticeresearchdatalink |