The morbidity of Clostridium difficile infection after elective colonic resection—results from a national population database

Lesperance, Kelly; Causey, Marlin Wayne; Spencer, Michael P.; Steele, Scott R.

doi:10.1016/j.amjsurg.2010.09.017

Cited by 19 publications

(30 citation statements)

References 37 publications

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“…A Canadian study cited an occurrence of 14.9 per 1000 postoperative hospitalized patients between 2003 and 2005. 21 Two previous US studies showed that the occurrence of CDAD following colectomy was 22,23 These rates are higher than in the colectomy group in our study (0.37%). The reason for this discrepancy may be that the high CDAD occurrence rates in the previous North American studies were associated with the emergence of a novel hypervirulent strain.…”

Section: Discussioncontrasting

confidence: 70%

The burden of Clostridium difficile-associated disease following digestive tract surgery in Japan

Yasunaga

Horiguchi

Hashimoto

et al. 2012

Journal of Hospital Infection

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Section: Discussioncontrasting

confidence: 70%

The burden of Clostridium difficile-associated disease following digestive tract surgery in Japan

Yasunaga

Horiguchi

Hashimoto

et al. 2012

Journal of Hospital Infection

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“…14–17 However, the recent time frame, diverse surgical population, and prospective data collection with 30-day follow-up are unique to this report. In the year the data were collected (2012-2013), the majority of Michigan hospitals had adopted PCR diagnostic testing methodology, which is more sensitive and specific and therefore has fewer false positive results.…”

Section: Discussionmentioning

confidence: 99%

Postoperative Burden of Hospital-Acquired Clostridium difficile Infection

Abdelsattar

Krapohl

Alrahmani

et al. 2015

Infect. Control Hosp. Epidemiol.

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Objective Clostridium difficile infection (CDI) is a common hospital-acquired infection. Previous reports on CDI's incidence, risk factors and impact on resources in the surgical population are limited. In this context, we study CDI across diverse surgical settings. Methods We prospectively identified patients with laboratory-confirmed postoperative CDI after 40 different general, vascular, or gynecologic surgeries at 52 academic & community hospitals between 7/2012-9/2013. We used multivariable regression models to identify CDI risk factors and its impact on resource utilization. Results Of 35,363 patients, 179 (0.51%) developed postoperative CDI. The highest rates of CDI were after lower-extremity amputation (2.6%), followed by bowel resection or repair (0.9%) and gastric or esophageal operations (0.7%). Gynecologic and endocrine operations had the lowest rates (0.1 & 0%, respectively). On multivariable analyses, older age, chronic immunosuppression, hypoalbuminemia (≤3.5 g/dL) and preoperative sepsis were associated with CDI. Use of prophylactic antibiotics was not independently associated with CDI, neither was sex, BMI, surgical priority, weight loss or comorbid conditions. Three procedure groups had higher odds of postoperative CDI: Lower-extremity amputations (aOR=3.5, p=0.03), gastric or esophageal operations (aOR=2.1, p=0.04) and bowel resection or repair (aOR=2, p=0.04). Postoperative CDI was independently associated with increased length of stay (mean 13.7 vs 4.5 days), emergency department presentations (18.9 vs 9.1%) and readmissions (38.9 vs 7.2%, all p<0.001). Conclusions Incidence of postoperative CDI varies by surgical procedure. Postoperative CDI is also associated with higher rates of extended length of stay, emergency room presentations & readmissions, which places a potentially preventable burden on hospital resources.

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“…Th e majority of costs were calculated over the duration of a hospital stay (39 studies, 87% ( 4-8,34,35,37-45,47,49-52, 54-70,72 )). In addition, the most common resource and cost source was large health administrative databases (29 studies, 64% ( 6,8,34,(37)(38)(39)(40)(41)(42)(43)(44)(45)(46)(47)(49)(50)(51)(52)(54)(55)(56)(57)(58)(59)(60)(61)63,65,69 )). …”

Section: Coi Study Characteristicsmentioning

confidence: 99%

“…Most studies met the following quality criteria: mentioned the time horizon for which costs were calculated over (45 studies, 100% (4)(5)(6)(7)(8)), stated the cost outcomes being evaluated (43 studies, 96% (4)(5)(6)(7)(8)34,), reported the resource utilization variables separately from unit costs (40 studies, 89% ( 4-8, 35-52,54-58,60,62-70,72,73 )), described the resource utilization and cost sources (38 studies, 84% (4)(5)(6)8,(37)(38)(39)(40)(41)(42)(43)(44)(45)(46)(47)(48)(49)(50)(51)(52)(54)(55)(56)(57)(58)(59)(60)(61)(63)(64)(65)(66)(67)(68)(69)(70)(71)…”

Section: Quality Assessment Of Coi Studiesmentioning

confidence: 99%