Obesity is associated with increased risk for death in most infections but has not been studied as a risk factor for mortality in Clostridioides difficile infection (CDI). This study tested obesity as a risk factor for death in patients hospitalized with CDI. This was a three-center retrospective study that included hospitalized adults with CDI at Columbia University Irving Medical Center, Brigham and Women’s Hospital, and NYU Langone from 2010 to 2018. Multivariate logistic regression was used to assess the relationship between obesity, measured by body mass index, and death from any cause within 30 days after the index CDI test. Data for 3851 patients were analyzed, including 373 (9.7%) who died within 30 days following a diagnosis of CDI. After adjusting for other factors, BMI was not associated with increased risk for death in any BMI category [adjusted OR (aOR) 0.96, 95% CI 0.69 to 1.34 for BMI > 30 vs BMI 20–30; aOR 1.02, 95% CI 0.53 to 1.87 for BMI > 40 vs BMI 20–30]. After stratifying into three groups by age, there were trends towards increased mortality with obesity in the middle-aged (56–75 vs ≤ 55 years old) yet decreased mortality with obesity in the old (> 75 vs ≤ 55) (p = NS for all). Advanced age and low albumin were the factors most strongly associated with death. We found no association between obesity and death among patients with CDI, in contrast to most other infections. Obesity is not likely to be useful for risk-stratifying hospitalized patients with CDI.

中文翻译：

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肥胖与艰难梭菌感染住院患者的不良结局无关

肥胖与大多数感染的死亡风险增加有关，但尚未将其作为艰难梭菌感染 (CDI) 死亡的风险因素进行研究。这项研究测试了肥胖作为 CDI 住院患者死亡的危险因素。这是一项三中心回顾性研究，包括 2010 年至 2018 年在哥伦比亚大学欧文医学中心、布莱根妇女医院和纽约大学朗格尼分校住院的 CDI 成人。多变量逻辑回归用于评估肥胖之间的关系，以体重衡量指数，以及在指数 CDI 测试后 30 天内因任何原因死亡。分析了 3851 名患者的数据，其中 373 名（9.7%）在诊断 CDI 后 30 天内死亡。调整其他因素后，BMI 与任何 BMI 类别的死亡风险增加无关[调整后的 OR (aOR) 0.96, 95% CI 0.69 至 1.34，BMI > 30 vs BMI 20-30；aOR 1.02, 95% CI 0.53 至 1.87 BMI > 40 与 BMI 20-30]。按年龄分为三组后，中年肥胖死亡率呈上升趋势（56-75 vs ≤ 55 岁），而老年人肥胖死亡率下降（> 75 vs ≤ 55）（p = NS对所有人）。高龄和低白蛋白是与死亡最密切相关的因素。与大多数其他感染相比，我们发现 CDI 患者的肥胖与死亡之间没有关联。肥胖不太可能对 CDI 住院患者的风险分层有用。按年龄分为三组后，中年肥胖死亡率呈上升趋势（56-75 vs ≤ 55 岁），而老年人肥胖死亡率下降（> 75 vs ≤ 55）（p = NS对所有人）。高龄和低白蛋白是与死亡最密切相关的因素。与大多数其他感染相比，我们发现 CDI 患者的肥胖与死亡之间没有关联。肥胖不太可能对 CDI 住院患者的风险分层有用。按年龄分为三组后，中年肥胖死亡率呈上升趋势（56-75 vs ≤ 55 岁），而老年人肥胖死亡率下降（> 75 vs ≤ 55）（p = NS对所有人）。高龄和低白蛋白是与死亡最密切相关的因素。与大多数其他感染相比，我们发现 CDI 患者的肥胖与死亡之间没有关联。肥胖不太可能对 CDI 住院患者的风险分层有用。与大多数其他感染相比，我们发现 CDI 患者的肥胖与死亡之间没有关联。肥胖不太可能对 CDI 住院患者的风险分层有用。与大多数其他感染相比，我们发现 CDI 患者的肥胖与死亡之间没有关联。肥胖不太可能对 CDI 住院患者的风险分层有用。