VCOM Research Day Program Book 2023

Medical Resident Research Cl inical

06 Relationship of Leukocytosis and Clostridium Difficile Colitis in Acute Care Setting

Sadia Iqbal; Autumn Jordan; Zachary Birch; Feras Ghosheh Corresponding author: Zachary.birch@hcahealthcare.com

HCA Lewisgale Hospital Montgomery-Blacksburg, VA

Clostridium Difficile is a prominent cause of nosocomial, antibiotic associated diarrhea, and pseudomembranous colitis. Several factors have been studied to potentially indicate a complicated course of Clostridium Difficile Infection. However, no study has linked leukocyte count alone as a predictor of diagnosis of C. difficile colitis. Using retrospective case-control data from HCA database, a total of over

35,000 patients were identified with enterocolitis, diarrhea, and leukocytosis. From these patients, logistic regression was used to predict the diagnosis of Clostridium Difficile infection (CDI) in patients with diarrhea. The mean WBC for case group (those with CDI) was 12.9 x 10 3 , whereas the control had a mean WBC of 9.27 3 . While the total number of patients diagnosed with CDI was low (171 patients), the AUC

value was 0.76 indicating a well-fitting model. Using the data, the optimal cut-off of WBC count of 11.36 x 10 3 was identified. This inference suggest that a person presenting with diarrhea and leukocytosis greater than 11.36 x 10 3 should be screened for CDI to allow for early diagnosis and treatment.

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