Aim: This study examines the association of decreased levels of serum proteins with the occurrence of Clostridium difficile-associated diarrhea (CDAD) in hospitalized patients.
Materials & methods: This is a retrospective case-control study using a case cohort (n = 171) that had been described in an earlier study and a cohort of 332 contemporaneous controls.
Results: Patients with CDAD had significantly lower serum levels of albumin, total protein and globulins, and decreased albumin/globulin ratio (p < 0.0001 for all parameters). After adjustment for confounders, hypoproteinemia was more closely associated with CDAD than either hypoalbuminemia or albumin/globulin ratio. Hypoproteinemia exhibited an odds ratios of 10.6 (95% CI: 6.62-17.0) after adjustment for race, and 11.0 (95% CI: 6.88-17.1) after adjustment for age.
Conclusion: Decreased total serum protein is more closely associated with CDAD than hypoalbuminemia.