Prolonged non-operative management of clostridium difficile colitis is associated with increased mortality, complications, and cost - 24/05/19
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.
El texto completo de este artículo está disponible en PDF.Highlights |
• | In surgical patients, prolonged non-operative care increases morbidity, mortality, and cost. |
• | Younger patients are more likely to undergo prolonged non-operative management. |
• | Patient gender and race are not associated with poor surgical outcomes for C difficile colitis. |
Keywords : Clostridium difficile, Mortality, Colectomy, Non-operative treatment, Outcomes
Esquema
Vol 217 - N° 6
P. 1042-1046 - juin 2019 Regresar al número
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