BACKGROUND: We hypothesized that colectomy for fulminant Clostridium difficile colitis (CDC) before organ failure would be associated with decreased mortality. METHODS: Data were retrospectively collected on patients operated on for CDC between 2000 and 2007. Variables examined included age, sex, immunodeficiency, recurrent CDC, vasopressor requirement, acute respiratory failure, acute renal failure, white blood cell count, and stress ulcer prophylaxis. Univariate and multivariate analyses were performed to identify predictors of mortality. RESULTS: During this period, 6,841 patients were diagnosed with CDC and 69 patients underwent surgery. Independent predictors of mortality were age >65 years (odds ratio [OR] 6.8, confidence interval [CI] 1.4-32.3, P = .016), acute respiratory failure (OR 5.4, CI 1.6-18.1, P = .007), and acute renal failure (OR 3.8, CI 1.1-13.1, P = .035). CONCLUSIONS: Colectomy before the development of organ failure is associated with decreased mortality in patients with fulminant CDC, especially in those >65 years old.
BACKGROUND: We hypothesized that colectomy for fulminant Clostridium difficilecolitis (CDC) before organ failure would be associated with decreased mortality. METHODS: Data were retrospectively collected on patients operated on for CDC between 2000 and 2007. Variables examined included age, sex, immunodeficiency, recurrent CDC, vasopressor requirement, acute respiratory failure, acute renal failure, white blood cell count, and stress ulcer prophylaxis. Univariate and multivariate analyses were performed to identify predictors of mortality. RESULTS: During this period, 6,841 patients were diagnosed with CDC and 69 patients underwent surgery. Independent predictors of mortality were age >65 years (odds ratio [OR] 6.8, confidence interval [CI] 1.4-32.3, P = .016), acute respiratory failure (OR 5.4, CI 1.6-18.1, P = .007), and acute renal failure (OR 3.8, CI 1.1-13.1, P = .035). CONCLUSIONS: Colectomy before the development of organ failure is associated with decreased mortality in patients with fulminant CDC, especially in those >65 years old.
Authors: Maximilian Lee; Andrew A Shelton; Waldo L Concepcion; Clark A Bonham; Tami J Daugherty Journal: Dig Dis Sci Date: 2010-07-16 Impact factor: 3.199
Authors: Gwendolyn M van der Wilden; Melanie P Subramanian; Yuchiao Chang; Lawrence Lottenberg; Robert Sawyer; Stephen W Davies; Paula Ferrada; Jinfeng Han; Alec Beekley; George C Velmahos; Marc A de Moya Journal: Surg Infect (Larchmt) Date: 2015-06-12 Impact factor: 2.150
Authors: Amelia M Kasper; Humaa A Nyazee; Deborah S Yokoe; Jeanmarie Mayer; Julie E Mangino; Yosef M Khan; Bala Hota; Victoria J Fraser; Erik R Dubberke Journal: Infect Control Hosp Epidemiol Date: 2012-03-20 Impact factor: 3.254