Early Administration of Intracolonic Vancomycin Enema May Improves Survival in Patients with Severe Clostridium difficile Colitis
Bibliographic record
Abstract
Purpose:Clostridium difficile colitis (CDC) is a major contributor to nosocomial morbidity and mortality (1). There is limited data on the effectiveness of intracolonic vancomycin enemas on mortality in CDC. Our study aims to observe difference in mortality based on the dose of ICV enemas, frequency of administration, degree of disease severity (2), and days delay to initiation of ICV from a positive Clostridium. difficile toxin test (CDTT). Methods: A retrospective chart review was performed on 61 patients who received ICV enemas from 2003 to 2011. Twenty-four cases met our inclusion criteria with confirmed positive CDTT and severity score index (SSI) above 4. A standardized form was used to collect severity score data and other variables all between 72 hours of a positive CDTT. SPSS statistical software was used to calculate chi-square and independent sample t-tests. Results: Twenty-four patients met inclusion criteria, 23 male and 1 female. The age range was from 54 years old to 86 years old. A moderate and severe score was noted in 75% and 25% of patients respectively. Our survival rate was 54. 2%. There was a positive correlation between an earlier administration of ICV and survival (p = 0.046). Conclusion: Our data suggests earlier administration of ICV does benefit survival in patients with CDC. The analysis showed the effect of dose, frequency, or severity of illness on mortality was not statistically significant, however the low number of cases limited our analysis. References. 1. Pepin, J., Valiquette, L., Cossete, B. Mortality attributable to nosocomial Clostridium difficile -associated disease during an epidemic caused by a hypervirulent strain in Quebec. CMAJ 2005; 173:1037-42 2. Toro, H.D, Amaral-Mojica M.K., Rocha-Rodriguez R., Gutierrez-Nunez J. An Innovative Severity Score Index for Clostridium difficile infection. Infectious Disease in Clinical Practice. 2011: 19;5: 336-339.Table 1: No Caption available.Table 2: No Caption available.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".