Post-Discharge Outcomes of Elderly Patients Hospitalized for Inflammatory Bowel Disease Flare Complicated by Clostridioides difficile Infection - Report - MDSpire

Post-Discharge Outcomes of Elderly Patients Hospitalized for Inflammatory Bowel Disease Flare Complicated by Clostridioides difficile Infection

  • By

  • Idan Goren

  • Ortal Fallek Boldes

  • Tomer Boldes

  • Oleg Knyazev

  • Anna Kagramanova

  • Jimmy K Limdi

  • Eleanor Liu

  • Karishma Sethi-Arora

  • Tom Holvoet

  • Piotr Eder

  • Cristina Bezzio

  • Simone Saibeni

  • Marta Vernero

  • Eleonora Alimenti

  • María Chaparro

  • Javier P Gisbert

  • Eleni Orfanoudaki

  • Ioannis E Koutroubakis

  • Daniela Pugliese

  • Giuseppe Cuccia

  • Cristina Calviño Suarez

  • Davide Giuseppe Ribaldone

  • Ido Veisman

  • Kassem Sharif

  • Stefano Festa

  • Annalisa Aratari

  • Claudio Papi

  • Iordanis Mylonas

  • Gerassimos J Mantzaris

  • Marie Truyens

  • Triana Lobaton Ortega

  • Stéphane Nancey

  • Fabiana Castiglione

  • Olga Maria Nardone

  • Giulio Calabrese

  • Konstantinos Karmiris

  • Magdalini Velegraki

  • Angeliki Theodoropoulou

  • Ariella Bar-Gil Shitrit

  • Milan Lukas

  • Gabriela Vojtechová

  • Pierre Ellul

  • Luke Bugeja

  • Edoardo V Savarino

  • Tali Sharar Fischler

  • Iris Dotan

  • Henit Yanai

  • October 21, 2024

  • 0 min

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Outcomes After Hospital Discharge in Elderly IBD Patients with CDI Complications

Overview

In elderly patients hospitalized for inflammatory bowel disease (IBD) flare, concurrent Clostridioides difficile infection (CDI) was not associated with increased post-discharge complications or mortality up to one year. The study found similar rates of IBD-related complications and mortality between CDI-positive and CDI-negative groups.

Background

Inflammatory bowel diseases, including Crohn’s disease and ulcerative colitis, affect patients across all ages, with a growing elderly population presenting unique management challenges. CDI is a known trigger for IBD flares and is more common in IBD patients, especially those over 65 years. Prior studies have shown conflicting results regarding the impact of CDI on post-discharge outcomes in IBD patients. This study aimed to clarify the effect of CDI on short-, intermediate-, and long-term outcomes in elderly hospitalized IBD patients.

Data Highlights

OutcomeCDI-Positive (%)CDI-Negative (%)p-value
3-month post-discharge complications32.033.10.8
6-month post-discharge complications40.542.50.66
12-month mortality4.68.00.153

Key Findings

  • Among 654 elderly IBD patients hospitalized for flare, 23.4% tested positive for CDI.
  • Post-discharge IBD-related complication rates at 3 and 6 months did not differ significantly between CDI-positive and CDI-negative groups.
  • Mortality at 12 months was not significantly higher in CDI-positive patients compared to CDI-negative patients.
  • The Charlson comorbidity index was the only significant risk factor for 3-month complications (adjusted odds ratio [aOR] 1.1).
  • Use of mesalamine (5-ASA) was protective against 3-month complications (aOR 0.6).
  • Ulcerative colitis diagnosis was a risk factor for complications at 6 months (aOR 1.5).

Clinical Implications

Clinicians should recognize that concurrent CDI in elderly patients hospitalized for IBD flare does not independently increase the risk of post-discharge complications or mortality. Management strategies should focus on comorbidity burden and IBD subtype rather than CDI status alone. Use of mesalamine may confer protective benefits in reducing early post-discharge complications.

Conclusion

In elderly patients hospitalized for IBD flare, concurrent CDI does not significantly impact post-discharge IBD-related complications or mortality up to one year. Comorbidity burden and ulcerative colitis diagnosis are more relevant predictors of adverse outcomes.

References

  1. ENTRIT Study Group 2024 -- Outcomes After Hospital Discharge in Older Adults with IBD Flare and CDI Complications

Original Source(s)

Post-Discharge Outcomes of Elderly Patients Hospitalized for Inflammatory Bowel Disease Flare Complicated by Clostridioides difficile Infection

  • by Idan Goren, Ortal Fallek Boldes, Tomer Boldes, Oleg Knyazev, Anna Kagramanova, Jimmy K Limdi, Eleanor Liu, Karishma Sethi-Arora, Tom Holvoet, Piotr Eder, Cristina Bezzio, Simone Saibeni, Marta Vernero, Eleonora Alimenti, María Chaparro, Javier P Gisbert, Eleni Orfanoudaki, Ioannis E Koutroubakis, Daniela Pugliese, Giuseppe Cuccia, Cristina Calviño Suarez, Davide Giuseppe Ribaldone, Ido Veisman, Kassem Sharif, Stefano Festa, Annalisa Aratari, Claudio Papi, Iordanis Mylonas, Gerassimos J Mantzaris, Marie Truyens, Triana Lobaton Ortega, Stéphane Nancey, Fabiana Castiglione, Olga Maria Nardone, Giulio Calabrese, Konstantinos Karmiris, Magdalini Velegraki, Angeliki Theodoropoulou, Ariella Bar-Gil Shitrit, Milan Lukas, Gabriela Vojtechová, Pierre Ellul, Luke Bugeja, Edoardo V Savarino, Tali Sharar Fischler, Iris Dotan, Henit Yanai

  • October 21, 2024

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