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AIM To examine whether age alone or comorbidity is a risk factor for death in older adults who developed Clostridium difficile (Cd)colitis during hospitalization.METHODS A retrospective, observational study design was performed in our Lady of Mercy Medical Center, a 650-bed, urban,community-based, university-affiliated teaching hospital. 121 patients with a positive diagnosis of Cd colitis (aged 23- 97 years) were studied, and data pertinent to demographic variables,medical history, co-morbidity, physical examination, and laboratory results were collected. Age was examined as a continuous variable and stratified into Age1 (＜80 vs 80 + );Age2 ( ＜ 60, 60 - 69, 70 - 79 and 80 + ); or Age3 (＜ 60, 60 - 69, 70 - 79, 80 - 89, 90 + ).RESULTS Cd colitis occurs more frequently with advancing age (55% of cases ＞80 years).However, age, per se, had no effect on mortality. A history of cardiac disease (P= 0.036), recurrent or refractory infection ＞4 weeks (P--0.007), Iow serum total protein (P=0.034), Iow serum albumin (P=0.001),antibiotic use ＞4 weeks (P＜0.010), use of over 4 antibiotics (P=0.026), and use of certain classes of antibiotics (P = 0.035 - 0.004) were predictive of death. Death was strongly predicted by the use of penicillin-like antibiotics plus clindamycin, in the presence of hypoalbuminemia, refractory sepsis, and cardiac disease ( P = 0.00005). CONCLUSION Cd colitis is common in the very old. However, unlike co-morbidity, age alone does not affect the clinical outcome (survival vs death).
