Colectomy for fulminant Clostridium difficile colitis

Predictors of mortality

Anton Dias Perera, Robert P. Akbari, Michael S. Cowher, Thomas E. Read, James T. Mccormick, David S. Medich, James P. Celebrezze, Sandra J. Beck, Peter Fischer, Philip F. Caushaj

Research output: Contribution to journalArticle

30 Citations (Scopus)

Abstract

The purpose of this study was to define clinical and radiographic variables associated with postoperative mortality after urgent colectomy for fulminant Clostridium difficile colitis. Data were obtained regarding patients undergoing colectomy for fulminant C. difficile colitis at two institutions (1997-2005). Univariate analysis of factors predicting 30-day mortality was performed using χ2 and Student's t tests. Multivariable logistic regression was done to include all variables whose P value was < 0.20. Clinical variables analyzed included: age, gender, recent operation, comorbidities, preoperative multisystem organ failure, vasopressors, symptom duration, time to surgery, serum albumin, change in serum albumin, serum creatinine, white blood cell count, and extent of colectomy. Computed tomography variables included: ascites, megacolon, and extent of colitis. Thirty-five patients (mean age 70 years, 46% male) underwent urgent colectomy for C. difficile colitis. The 30-day mortality rate was 45.7 per cent (16/35). The only clinical variable associated with mortality was preoperative multisystem organ failure (non-survivors 9/16 vs survivors: 4/19; P = 0.037). None of the three patients undergoing partial colectomy survived, although the difference in survival versus those undergoing subtotal colectomy was not significant. Patients with fulminant C. difficile colitis undergoing colectomy have a high mortality rate. Preoperative presence of multisystem organ failure was independently predictive of mortality.

Original languageEnglish (US)
Pages (from-to)418-421
Number of pages4
JournalAmerican Surgeon
Volume76
Issue number4
StatePublished - Apr 1 2010

Fingerprint

Clostridium difficile
Colectomy
Colitis
Mortality
Serum Albumin
Megacolon
Leukocyte Count
Ascites
Statistical Factor Analysis
Survivors
Comorbidity
Creatinine
Logistic Models
Tomography
Students
Survival
Serum

All Science Journal Classification (ASJC) codes

  • Surgery

Cite this

Perera, A. D., Akbari, R. P., Cowher, M. S., Read, T. E., Mccormick, J. T., Medich, D. S., ... Caushaj, P. F. (2010). Colectomy for fulminant Clostridium difficile colitis: Predictors of mortality. American Surgeon, 76(4), 418-421.

Colectomy for fulminant Clostridium difficile colitis : Predictors of mortality. / Perera, Anton Dias; Akbari, Robert P.; Cowher, Michael S.; Read, Thomas E.; Mccormick, James T.; Medich, David S.; Celebrezze, James P.; Beck, Sandra J.; Fischer, Peter; Caushaj, Philip F.

In: American Surgeon, Vol. 76, No. 4, 01.04.2010, p. 418-421.

Research output: Contribution to journalArticle

Perera, AD, Akbari, RP, Cowher, MS, Read, TE, Mccormick, JT, Medich, DS, Celebrezze, JP, Beck, SJ, Fischer, P & Caushaj, PF 2010, 'Colectomy for fulminant Clostridium difficile colitis: Predictors of mortality', American Surgeon, vol. 76, no. 4, pp. 418-421.
Perera AD, Akbari RP, Cowher MS, Read TE, Mccormick JT, Medich DS et al. Colectomy for fulminant Clostridium difficile colitis: Predictors of mortality. American Surgeon. 2010 Apr 1;76(4):418-421.
Perera, Anton Dias ; Akbari, Robert P. ; Cowher, Michael S. ; Read, Thomas E. ; Mccormick, James T. ; Medich, David S. ; Celebrezze, James P. ; Beck, Sandra J. ; Fischer, Peter ; Caushaj, Philip F. / Colectomy for fulminant Clostridium difficile colitis : Predictors of mortality. In: American Surgeon. 2010 ; Vol. 76, No. 4. pp. 418-421.
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