BACKGROUND: The prevalence of Clostridium difficile colitis is reportedly increasing in surgical patients and can negatively impact their outcome. However, as yet there are no clear estimates of the C difficile infection colitis rate and its consequences among patients undergoing total joint arthroplasty (TJA). QUESTIONS/PURPOSES: We asked: (1) What is the rate of C difficile colitis in TJA patients? (2) What are the risk factors of C difficile colitis in these patients? And (3) what is the effect of C difficile colitis on length of stay, in-hospital mortality, and estimated total charges? METHODS: Using ICD-9-CM diagnosis and procedure codes, we queried the Nationwide Inpatient Sample database for patients undergoing TJA for the years 2002 to 2010. Demographic data, comorbidities, occurrence of C difficile colitis, length of hospital stay, mortality, and hospital charges were extracted. Logistic regression was performed to identify predictors of C difficile colitis and its impact on in-hospital mortality. RESULTS: The incidence of C difficile remained less than 0.6% during the study period. Revision TJAs (odds ratio=6.9 and 4.4 for hip and knee, respectively) and number of comorbidities (odds ratio=1.5) increased risk of C difficile colitis. C difficile increased length of hospital stay by a week, hospital charges by USD 40,000, and in-hospital mortality to 4.66% from 0.24%. CONCLUSIONS: Using lower and fewer doses of antibiotics in revision TJAs and among patients with many comorbidities may diminish risk of C difficile colitis and its consequent mortality. LEVEL OF EVIDENCE: Level II, prognostic study. See Instructions for Authors for a complete description of levels of evidence.
BACKGROUND: The prevalence of Clostridium difficilecolitis is reportedly increasing in surgical patients and can negatively impact their outcome. However, as yet there are no clear estimates of the C difficile infection colitis rate and its consequences among patients undergoing total joint arthroplasty (TJA). QUESTIONS/PURPOSES: We asked: (1) What is the rate of C difficile colitis in TJA patients? (2) What are the risk factors of C difficile colitis in these patients? And (3) what is the effect of C difficile colitis on length of stay, in-hospital mortality, and estimated total charges? METHODS: Using ICD-9-CM diagnosis and procedure codes, we queried the Nationwide Inpatient Sample database for patients undergoing TJA for the years 2002 to 2010. Demographic data, comorbidities, occurrence of C difficile colitis, length of hospital stay, mortality, and hospital charges were extracted. Logistic regression was performed to identify predictors of C difficile colitis and its impact on in-hospital mortality. RESULTS: The incidence of C difficile remained less than 0.6% during the study period. Revision TJAs (odds ratio=6.9 and 4.4 for hip and knee, respectively) and number of comorbidities (odds ratio=1.5) increased risk of C difficile colitis. C difficile increased length of hospital stay by a week, hospital charges by USD 40,000, and in-hospital mortality to 4.66% from 0.24%. CONCLUSIONS: Using lower and fewer doses of antibiotics in revision TJAs and among patients with many comorbidities may diminish risk of C difficile colitis and its consequent mortality. LEVEL OF EVIDENCE: Level II, prognostic study. See Instructions for Authors for a complete description of levels of evidence.
Authors: Marc Zerey; B Lauren Paton; Amy E Lincourt; Keith S Gersin; Kent W Kercher; B Todd Heniford Journal: Surg Infect (Larchmt) Date: 2007-12 Impact factor: 2.150
Authors: Patawut Bovonratwet; Daniel D Bohl; Glenn S Russo; Nathaniel T Ondeck; Denis Nam; Craig J Della Valle; Jonathan N Grauer Journal: Clin Orthop Relat Res Date: 2018-03 Impact factor: 4.176
Authors: Scott J Douglas; Ethan A Remily; Oliver C Sax; Sahir S Pervaiz; Evan B Polsky; Ronald E Delanois Journal: Clin Orthop Relat Res Date: 2021-12-01 Impact factor: 4.176
Authors: Jacqueline Färber; Sebastian Illiger; Fabian Berger; Barbara Gärtner; Lutz von Müller; Christoph H Lohmann; Katja Bauer; Christina Grabau; Stefanie Zibolka; Dirk Schlüter; Gernot Geginat Journal: Antimicrob Resist Infect Control Date: 2017-02-15 Impact factor: 4.887
Authors: Alexandre R Marra; Eli N Perencevich; Richard E Nelson; Matthew Samore; Karim Khader; Hsiu-Yin Chiang; Margaret L Chorazy; Loreen A Herwaldt; Daniel J Diekema; Michelle F Kuxhausen; Amy Blevins; Melissa A Ward; Jennifer S McDanel; Rajeshwari Nair; Erin Balkenende; Marin L Schweizer Journal: JAMA Netw Open Date: 2020-01-03
Authors: Javier Z Guzman; Branko Skovrlj; Edward S Rothenberg; Young Lu; Steven McAnany; Samuel K Cho; Andrew C Hecht; Sheeraz A Qureshi Journal: Global Spine J Date: 2015-08-10