Prolonged non-operative management of clostridium difficile colitis is associated with increased mortality, complications, and cost

Bradley R. Hall, Priscila R. Armijo, Jennifer A. Leinicke, Sean J. Langenfeld, Dmitry Oleynikov

Research output: Contribution to journalArticle

Abstract

Background: We aim to investigate the effects of delaying surgery on outcomes and cost in patients admitted with severe clostridium difficile infection (CDI). Methods: The Vizient database was queried for patients with CDI who underwent open total abdominal colectomy (TAC). Patients operated on the day of admission were excluded. Chi-square, Fisher's exact, student T-test, and logistic regression were performed with α = 0.05. Results: Logistic regression analyses using days from admission to surgery (DATO), age, race, and gender demonstrated that increased DATO was associated with higher 30-day mortality (OR 1.022, 95% CI 1.001–1.044, p = 0.040), overall complications (OR 1.034, 95% CI 1.014–1.054, p = 0.001), and infectious complications (OR 1.040, 95% CI 1.018–1.062, p < 0.001)compared to age for all three outcomes. Total length of stay (LOS), intensive care unit LOS, and direct cost increased in conjunction with DATO (p < 0.001). Conclusions: Early surgical intervention in appropriately selected patients should be considered when there is a high suspicion for prolonged non-operative treatment.

Original languageEnglish (US)
Pages (from-to)1042-1046
Number of pages5
JournalAmerican journal of surgery
Volume217
Issue number6
DOIs
StatePublished - Jun 2019

Keywords

  • Clostridium difficile
  • Colectomy
  • Mortality
  • Non-operative treatment
  • Outcomes

ASJC Scopus subject areas

  • Surgery

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