Recurrent Clostridioides difficile infection worsens anxiety-related patient-reported quality of life

Journal of Patient-Reported Outcomes

Table 2 Changes in health-related quality of life (HrQOL) scores at baseline and follow-up

	No. of patients (%)	HrQOL score (mean ± SD)		Change in HrQOL score
	No. of patients (%)	Baseline	Follow-Up	Change in HrQOL score
Overall	144	26.4 ± 11.5	56.1 ± 25.0	29.7
Demographics
Age in years, mean ± SD	68 ± 15
Female	91 (63.2)	25.9 ± 11.7	54.4 ± 39.5	28.5
Male	53 (36.8)	27.2 ± 12.0	58.9 ± 44.3	31.8
Charlson index, median [IQR]	4 [3,4,5,6]
CDI history prior to bezlotoxumab
Primary CDI	24 (16.7)	34.5 ± 17.1	63.2 ± 46.3	28.7
1 CDI recurrence	35 (24.3)	22.4 ± 8.7	40.0 ± 21.8	17.6
2 CDI recurrences	44 (30.6)	26.9 ± 12.1	60.0 ± 50.1	33.1
≥ 3 CDI recurrences	41 (28.5)	24.3 ± 10.3	53.6 ± 38.5	29.3
CDI risk factors
≥ 65 years of age	100 (69.4)	28.0 ± 12.7	59.1 ± 49.2	31.1
≥ 1 CDI episode in previous 6 months	112 (77.9)	24.2 ± 10.1	55.0 ± 40.3	30.8
Immunocompromised condition^a	53 (36.8)	20.2 ± 7.2	52.6 ± 37.8	32.4
Gastric acid suppressant use^b	46 (31.9)	21.2 ± 7.9	50.1 ± 34.6	28.9
Current episode with severe presentation^c	31 (21.5)	28.1 ± 12.8	63.8 ± 49.1	35.7
Inflammatory bowel disease	12 (8.3)	22.4 ± 8.3	45.5 ± 29.8	23.1
Chronic renal disease	12 (8.3)	31.2 ± 15.5	42.9 ± 27.0	11.7
Prior failed FMT	17 (11.8)	22.7 ± 9.3	56.3 ± 40.1	33.6
Clinical outcome 90 days post bezlotoxumab
rCDI	23 (15.9)	22.0 ± 8.9	28.7 ± 13.5	6.7
No further rCDI	121 (84.1)	27.2 ± 12.0	61.3 ± 46.5	34.1

Patient-reported answers to an adapted Clostridioides difficile quality of life survey (Cdiff32) [3] were recorded at baseline (prior to bezlotoxumab) and again at follow-up (90 days post bezlotoxumab) and inverted to a scale between 0 (worst HrQOL) and 100 (best HrQOL)
^aDue to immunosuppressive medication or underlying disease (immune deficiency, solid organ or hematopoietic stem cell transplant, absolute neutrophil cell count < 500 cells/µL)
^bProton pump inhibitor and histamine-2 receptor antagonist
^cDefined by any of the following: albumin ≤ 3.0 g/dL, serum creatinine ≥ 1.5 times above baseline, hypotension or shock, intensive care unit stay related to CDI, ileus, serum lactate > 5 mmol/L, toxic megacolon or colectomy related to CDI, white blood cell count ≥ 15,000 cells/µL