Clostridium difficile infection after colorectal surgery: a rare but costly complication
Authors
Damle, Rachelle N.Cherng, Nicole B.
Flahive, Julie
Davids, Jennifer S.
Maykel, Justin A.
Sturrock, Paul R.
Sweeney, W. Brian
Alavi, Karim
Student Authors
Prabhakar MithalFaculty Advisor
Karim Alavi, MD/SurgeryDocument Type
Journal ArticlePublication Date
2014-10-01Keywords
AdolescentAdult
Clostridium difficile
Colorectal Surgery
Cost-Benefit Analysis
Enterocolitis, Pseudomembranous
Female
Follow-Up Studies
Hospital Costs
Humans
Length of Stay
Male
Middle Aged
Prevalence
Prognosis
Retrospective Studies
Risk Assessment
Risk Factors
Surgical Wound Infection
Time Factors
United States
Young Adult
Surgery
Metadata
Show full item recordAbstract
BACKGROUND: The incidence and virulence of Clostridium difficile infection (CDI) are on the rise. The characteristics of patients who develop CDI following colorectal resection have been infrequently studied. MATERIALS AND METHODS: We utilized the University HealthSystem Consortium database to identify adult patients undergoing colorectal surgery between 2008 and 2012. We examined the patient-related risk factors for CDI and 30-day outcomes related to its occurrence. RESULTS: A total of 84,648 patients met our inclusion criteria, of which the average age was 60 years and 50% were female. CDI occurred in 1,266 (1.5%) patients during the years under study. The strongest predictors of CDI were emergent procedure, inflammatory bowel disease (IBD), and major/extreme APR-DRG severity of illness score. CDI was associated with a higher rate of complications, intensive care unit (ICU) admission, longer preoperative inpatient stay, 30-day readmission rate, and death within 30 days compared to non-CDI patients. Cost of the index stay was, on average, $14,130 higher for CDI patients compared with non-CDI patients. CONCLUSION: Emergent procedures, higher severity of illness, and inflammatory bowel disease are significant risk factors for postoperative CDI in patients undergoing colorectal surgery. Once established, CDI is associated with worse outcomes and higher costs. The poor outcomes of these patients and increased costs highlight the importance of prevention strategies targeting high-risk patients.Source
J Gastrointest Surg. 2014 Oct;18(10):1804-11. doi: 10.1007/s11605-014-2600-7. Epub 2014 Aug 5. Link to article on publisher's siteDOI
10.1007/s11605-014-2600-7Permanent Link to this Item
http://hdl.handle.net/20.500.14038/49283PubMed ID
25091840Notes
Nichole Cherng participated in this study as a medical student as part of the Senior Scholars research program at the University of Massachusetts Medical School.
Related Resources
Link to Article in PubMedae974a485f413a2113503eed53cd6c53
10.1007/s11605-014-2600-7