Kai B Dallas1, Audree Condren1, Celia M Divino2. 1. Department of Surgery, The Mount Sinai School of Medicine, One Gustave L. Levy Place, Box 1259, New York, NY 10029, USA. 2. Department of Surgery, The Mount Sinai School of Medicine, One Gustave L. Levy Place, Box 1259, New York, NY 10029, USA. Electronic address: celia.divino@mssm.edu.
Abstract
BACKGROUND: The long-term prognosis of patients undergoing colectomy for fulminant Clostridium difficile colitis has not been well studied. The authors present 7-year survival trends in such patients. METHODS: Patients were identified through a pathologic database. Medical records were reviewed and follow-up phone calls made to determine relevant patient history, longevity, and quality of life. RESULTS: The 61 patients identified had mean and median survival of 18.1 and 3.2 months, respectively, and 1-year, 2-year, 5-year, and 7-year mortality of 68.5%, 79.6%, 88.9%, and 90.7%, respectively. Previous C difficile infection, hypotension, requirement of vasopressors, mental status changes, elevated arterial lactate, decreased platelet counts, intubation, and longer duration on nonoperative therapy were associated with in-hospital mortality. There were no factors correlated with long-term survival. CONCLUSIONS: Patients who require colectomy for fulminant C difficile colitis have a poor prognosis with poor long-term survival and significant morbidity. Although there are several factors associated with in-hospital mortality, there were no factors correlated with long-term survival.
BACKGROUND: The long-term prognosis of patients undergoing colectomy for fulminant Clostridium difficilecolitis has not been well studied. The authors present 7-year survival trends in such patients. METHODS:Patients were identified through a pathologic database. Medical records were reviewed and follow-up phone calls made to determine relevant patient history, longevity, and quality of life. RESULTS: The 61 patients identified had mean and median survival of 18.1 and 3.2 months, respectively, and 1-year, 2-year, 5-year, and 7-year mortality of 68.5%, 79.6%, 88.9%, and 90.7%, respectively. Previous C difficile infection, hypotension, requirement of vasopressors, mental status changes, elevated arterial lactate, decreased platelet counts, intubation, and longer duration on nonoperative therapy were associated with in-hospital mortality. There were no factors correlated with long-term survival. CONCLUSIONS:Patients who require colectomy for fulminant C difficile colitis have a poor prognosis with poor long-term survival and significant morbidity. Although there are several factors associated with in-hospital mortality, there were no factors correlated with long-term survival.
Authors: Emily N Tixier; Elijah Verheyen; Yuying Luo; Lauren Tal Grinspan; Charles H Du; Ryan C Ungaro; Samantha Walsh; Ari M Grinspan Journal: Dig Dis Sci Date: 2021-03-22 Impact factor: 3.199