Post-Discharge Outcomes of Elderly Patients Hospitalized for Inflammatory Bowel Disease Flare Complicated by Clostridioides difficile Infection.
| Title: | Post-Discharge Outcomes of Elderly Patients Hospitalized for Inflammatory Bowel Disease Flare Complicated by Clostridioides difficile Infection. |
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| Authors: | Goren I; Division of Gastroenterology, Rabin Medical Center, Affiliated with the Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv, Israel.; Division of Gastroenterology, SUNY Upstate Medical University, Syracuse, NY, USA.; Fallek Boldes O; Department of Internal Medicine E, Rabin Medical Center, Affiliated with the Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv, Israel.; Boldes T; Department of Otolaryngology, Meir Medical Center, Affiliated with the Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv, Israel.; Knyazev O; Moscow Clinical Scientific Center named after A. S. Loginov, Moscow, Russia.; National Medical Research Center of Coloproctology named after A. N. Ryzhykh, Moscow, Russia.; Kagramanova A; Moscow Clinical Scientific Center named after A. S. Loginov, Moscow, Russia.; Research Institute of Health Organization and Medical Management, Moscow, Russia.; Limdi JK; Division of Gastroenterology, Northern Care Alliance Hospitals NHS Foundation Trust, Manchester, UK.; Faculty of Biology, Medicine & Health, University of Manchester, Manchester, UK.; Liu E; Faculty of Biology, Medicine & Health, University of Manchester, Manchester, UK.; Sethi-Arora K; Division of Gastroenterology, Northern Care Alliance Hospitals NHS Foundation Trust, Manchester, UK.; Holvoet T; Department of Gastroenterology, VITAZ, St Niklaas, Belgium.; Department of Gastroenterology, University Hospital Ghent, Ghent, Belgium.; Eder P; Department of Gastroenterology, Dietetics and Internal Medicine, Poznan University of Medical Sciences, Poznan, Poland.; Bezzio C; IBD Center, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy.; Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy.; Saibeni S; Department of Gastroenterology, ASST Rhodense, Rho, Italy.; Vernero M; Department of Gastroenterology, ASST Rhodense, Rho, Italy.; Department of Medical Sciences, University of Turin, Turin, Italy.; Alimenti E; Department of Gastroenterology, ASST Rhodense, Rho, Italy.; Department of Medical Sciences, University of Pavia, Gastroenterology Unit, Pavia, Italy.; Chaparro M; Departement of Gastroenterology, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (JjS-Princesa), Universidad Autónoma de Madrid, and Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Madrid, Spain.; Gisbert JP; Departement of Gastroenterology, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (JjS-Princesa), Universidad Autónoma de Madrid, and Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Madrid, Spain.; Orfanoudaki E; Department of Gastroenterology, University Hospital of Heraklion, Heraklion, Greece.; Koutroubakis IE; Department of Gastroenterology, University Hospital of Heraklion, Heraklion, Greece.; Pugliese D; CEMAD - IBD UNIT - Unità Operativa Complessa di Medicina Interna e Gastroenterologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario 'A. Gemelli' IRCCS, Rome, Italy.; Cuccia G; Dipartimento Universitario di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome, Italy.; Calviño Suarez C; Department of Gastroenterology and Hepatology, University Hospital of Santiago de Compostela, La Coruña, Spain.; Ribaldone DG; Department of Medical Sciences, University of Turin, Turin, Italy.; Veisman I; Department of Gastroenterology, Sheba Medical Center, affiliated to Faculty of Medicine, Tel Aviv University, Israel, Department of Gastroenterology, Ramat Gan, Israel.; Sharif K; Department of Gastroenterology, Sheba Medical Center, affiliated to Faculty of Medicine, Tel Aviv University, Israel, Department of Gastroenterology, Ramat Gan, Israel.; Festa S; IBD Unit, San Filippo Neri Hospital, Rome, Italy.; Aratari A; Department of Gastroenterology, S. Filippo Neri Hospital, Gastroenterology, Rome, Italy and Department of Gastroenterology, Evangelismos-Polycliniki General Hospital, Athens, Greece.; Papi C; Department of Gastroenterology, S. Filippo Neri Hospital, Gastroenterology, Rome, Italy and Department of Gastroenterology, Evangelismos-Polycliniki General Hospital, Athens, Greece.; Mylonas I; Department of Gastroenterology, S. Filippo Neri Hospital, Gastroenterology, Rome, Italy and Department of Gastroenterology, Evangelismos-Polycliniki General Hospital, Athens, Greece.; Mantzaris GJ; Department of Gastroenterology, S. Filippo Neri Hospital, Gastroenterology, Rome, Italy and Department of Gastroenterology, Evangelismos-Polycliniki General Hospital, Athens, Greece.; Truyens M; Department of Gastroenterology, Evangelismos-Polycliniki General Hospital, Athens, Greece.; Lobaton Ortega T; Department of Internal Medicine and Pediatrics, Ghent University, Ghent, Belgium.; Nancey S; Dept. de Gastroenterologie, South Lyon University Hospital, Hospices Civils de Lyon, Lyon, France.; Castiglione F; Department of Clinical Medicine and Surgery, Federico Jj University, Gastroenterology, Naples, Italy.; Nardone OM; Department of Public Health, University of Naples Federico Jj, Gastroenterolog, Naples, Italy.; Calabrese G; Department of Public Health, University of Naples Federico Jj, Gastroenterolog, Naples, Italy.; Karmiris K; Department of Gastroenterology, Venizeleio General Hospital, Heraklion, Greece.; Velegraki M; Department of Gastroenterology, Venizeleio General Hospital, Heraklion, Greece.; Theodoropoulou A; Department of Gastroenterology, Venizeleio General Hospital, Heraklion, Greece.; Shitrit AB; IBD MOM Unit, Digestive Diseases Institute, Shaare Zedek Medical Center, affiliated with the Hebrew University, Jerusalem, Israel.; Lukas M; Clinical and Research Center for Inflammatory Bowel Disease ISCARE and First Faculty of Medicine, Charles University, Prague, Czech Republic.; Vojtechová G; Clinical and Research Center for Inflammatory Bowel Disease ISCARE and First Faculty of Medicine, Charles University, Prague, Czech Republic.; Ellul P; Division of Gastroenterology, Mater Dei Hospital, Birkirkara, Malta.; Bugeja L; Division of Gastroenterology, Mater Dei Hospital, Birkirkara, Malta.; Savarino EV; Department of Surgery, Oncology and Gastroenterology, Division of Gastroenterology, University of Padua, Padua, Italy.; Fischler TS; Division of Gastroenterology, Rabin Medical Center, Affiliated with the Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv, Israel.; Dotan I; Division of Gastroenterology, Rabin Medical Center, Affiliated with the Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv, Israel.; Yanai H; Division of Gastroenterology, Rabin Medical Center, Affiliated with the Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv, Israel. |
| Source: | Journal of Crohn's & colitis [J Crohns Colitis] 2025 May 08; Vol. 19 (5). |
| Publication Type: | Journal Article; Multicenter Study |
| Language: | English |
| Journal Info: | Publisher: Oxford University Press Country of Publication: England NLM ID: 101318676 Publication Model: Print Cited Medium: Internet ISSN: 1876-4479 (Electronic) Linking ISSN: 18739946 NLM ISO Abbreviation: J Crohns Colitis Subsets: MEDLINE |
| Imprint Name(s): | Publication: 2015- : Oxford : Oxford University Press; Original Publication: Amsterdam : Elsevier Science |
| MeSH Terms: | Clostridium Infections*/complications ; Clostridium Infections*/epidemiology ; Inflammatory Bowel Diseases*/complications; Hospitalization/statistics & numerical data ; Patient Readmission/statistics & numerical data ; Humans ; Female ; Male ; Aged ; Retrospective Studies ; Patient Discharge ; Risk Factors ; Middle Aged ; Symptom Flare Up ; Clostridioides difficile |
| Abstract: | Objectives: Elderly hospitalized patients with inflammatory bowel disease (IBD) flare and concurrent Clostridioides difficile infection (CDI) are considered at high risk of IBD-related complications. We aimed to evaluate the short-,intermediate-, and long-term post-discharge complications among these patients.; Methods: A retrospective multicenter cohort study assessing outcomes of elderly individuals (≥60 years) hospitalized for an IBD flare who were tested for CDI (either positive or negative) and discharged. The primary outcome was the 3-month post-discharge IBD-related complication rates defined as steroid dependency, re-admissions (emergency department or hospitalization), IBD-related surgery, or mortality. We assessed post-discharge IBD-related complications within 6 month and mortality at 12 month among secondary outcomes. Risk factors for complication were assessed by multivariable logistic regression.; Results: In a cohort of 654 patients hospitalized for IBD {age 68.9 (interquartile range [IQR]): 63.9-75.2 years, 60.9% ulcerative colitis (UC)}, 23.4% were CDI-positive. Post-discharge complication rates at 3 and 6 months, and 12 months mortality, did not differ significantly between CDI-positive and CDI-negative patients (32% vs 33.1%, p = 0.8; 40.5% vs 42.5%, p = 0.66; and 4.6% vs 8%, p = 0.153, respectively). The Charlson comorbidity index was the only significant risk factor for complications within 3 months (aOR 1.1), whereas mesalamine (5-aminosalicylic acid [5-ASA]) use was protective (aOR 0.6). An UC diagnosis was the sole risk factor for complication at 6 months (aOR 1.5). Clostridioides difficile infection did not significantly impact outcomes or interact with IBD type.; Conclusions: In elderly IBD patients hospitalized for IBD flare and subsequently discharged, a concurrent CDI infection was not associated with post-discharge IBD-related complications or mortality up to 1 year.; (© The Author(s) 2024. Published by Oxford University Press on behalf of European Crohn’s and Colitis Organisation. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.) |
| Comments: | Erratum in: J Crohns Colitis. 2025 May 8;19(5):jjaf071. doi: 10.1093/ecco-jcc/jjaf071.. (PMID: 40372820) |
| Contributed Indexing: | Keywords: Clostridioides difficile; Inflammatory bowel disease; elderly; hospitalization; mortality; outcomes |
| Entry Date(s): | Date Created: 20241022 Date Completed: 20250509 Latest Revision: 20250516 |
| Update Code: | 20260130 |
| DOI: | 10.1093/ecco-jcc/jjae161 |
| PMID: | 39435855 |
| Database: | MEDLINE |
Journal Article; Multicenter Study