Nonsteroidal Anti-Inflammatory Drugs Impact on the Outcomes of Hospitalized Patients with Clostridium difficile Infection

Figures & data

Table 1 Type of NSAID Used, Its Duration and Frequency of Use

Type of NSAID	Mean Duration of Use (Days)	Frequency of Use N(%)
Ibuprofen (Oral)	3 ± 2	31 (38.75%)
Ketorolac (Injection)	2 ± 2	45 (56.25%)
Naproxen (Oral)	2 ± 1	2 (2.5%)
Nabumetone (Oral)	2	1 (1.25%)
Indomethacin (Oral)	1	1 (1.25%)

Table 2 Baseline Clinical Characteristics Outlayed Between Patients Who Received NSAIDs versus Those Who Did Not Received NSAIDs

Characteristics	Patients Who Received NSAIDs (n=80)	Patients Who Did Not Receive NSAIDs (n= 488)	p Value
Age			0.003
Mean (Years)	52 ± 17.38	58 ± 16.15
Gender			0.938
Female	43 (53.7%)	260 (53.3%)
Male	37 (46.3%)	228 (46.7%)
Ethnicity			0.737
Hispanic	43 (54.4%)	257 (52.8%)
African American	25 (31.6%)	151 (31%)
Caucasian	7 (8.9%)	33 (6.8%)
Others	4 (5.1%)	45 (9.2%)
Native Americans	0	1 (0.2%)
Comorbidities
Hypertension	65 (81.3%)	343 (70.3%)	0.043
Diabetes Mellitus	49 (61.3%)	258 (52.9%)	0.163
Pneumonia	45 (56.3%)	286 (58.6%)	0.692
Sepsis	43 (53.8%)	231 (47.3%)	0.287
Congestive Heart Failure	28 (35%)	153 (31.4%)	0.516
Urinary Tract Infection	24 (30%)	162 (33.2%)	0.572
End Stage Renal Disease	11 (13.8%)	58 (11.9%)	0.636
Length of Stay (Days)	7 ± 8.37	6 ± 14.53	0.638
Laboratory Values
White Blood Cell Count (1000/µL)	16 ± 10	16 ± 8	0.552
Urea Nitrogen, Serum (mg/dL)	23 ± 18.69	38 ± 33.72	<0.001
Creatinine, Serum (mg/dL)	1.6427 ± 2.03	2.9734 ± 3.08	<0.001
Potassium, Serum (mEq/L)	3 ± 0.54	3 ± 0.723	0.536
Chloride, Serum (mEq/L)	95.6 ± 5.66	94.9 ± 9.83	0.549
Bicarbonate, Serum (mEq/L)	18 ± 4.49	17 ± 5.78	0.241
Lactate, Serum (mEq/L)	2 ± 1.87	3 ± 3.82	0.068

Table 3 Comparison of Severity of CDI for Patients Who Received NSAIDs versus Those Who Did Not Receive NSAIDs

Variable	Patients Who Received NSAIDs (n=80)	Patients Who Did Not Receive NSAIDs (n= 488)	p Value
Severity			0.661
Mild-to-moderate	57 (71.2%)	326 (66.8%)
Severe	14 (17.5%)	90 (18.4%)
Complicated	9 (11.3%)	72 (14.8%)

Table 4 Comparison of Primary Outcomes of CDI for Patients Who Received NSAIDs versus Those Who Did Not Receive NSAIDs

Variable	Patients Who Received NSAIDs (n=80)	Patients Who Did Not Receive NSAIDs (n= 488)	p Value
Toxic Mega-colon	2 (2.5%)	3 (0.6%)	0.094
All-Cause Mortality	10 (12.5%)	81 (16.6%)	0.354

Table 5 Mortality Outcomes When Controlled for the Severity of CDI Amongst Patients Who Received NSAIDs versus Those Who Did Not Receive NSAIDs

Severity	Patients Who Received NSAIDs	Patients Who Did Not Receive NSAIDs	p Value
Mild-to-moderate	n = 57	n = 326
All-cause mortality	3 (5.3%)	25 (7.7%)	0.52
Severe	n = 14	n = 90
All-cause mortality	3 (21.4%)	19 (21.1%)	0.978
Complicated	n = 9	n = 72
All-cause mortality	4 (44.4%)	37 (51.4%)	0.694

Table 6 Comparison of CDI Severity and Outcomes Among Patients Who Did and Did Not Receive Aspirin After the CDI Diagnosis

Variable	Patients Who Received Aspirin (n=27)	Patients Who Did Not Receive Aspirin (n=541)	p Value
Severity			0.645
Mild-to-moderate	16 (59.3%)	368 (68%)
Severe	6 (22.2%)	98 (18%)
Complicated	5 (18.5%)	76 (14%)
Toxic Mega-colon	1 (3.7%)	4 (0.7%)	0.108
All-Cause Mortality	4 (14.8%)	87 (16.1%)	0.861

Table 7 Binomial Logistic Regression for Predictors of Mortality

Variable	Odds Ratio	p Value
Age	1.011	0.345
Severity	3.686	<0.001
Toxic Megacolon	0	0.999
Patients who received NSAIDs	0.894	0.821
Elevated Values
White Blood Cell Count	1	0.991
Blood Urea Nitrogen, Serum	1.015	0.034
Creatinine, Serum	0.932	0.37
Lactate	1.157	0.008
Decreased Values
Potassium, Serum	1.059	0.81
Chloride, Serum	1.015	0.337
Bicarbonate, Serum	1.024	0.525

Note: Bold text: on regression analysis, severity of Clostridium difficile infection, serum BUN and lactate levels were significant predictors of mortality. NSAID use was not found to be a significant predictor of mortality.