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Published on: December 8, 2014
A multicenter study of Clostridium difficile infection-related colectomy, 2000-2006
Amelia M Kasper1, Humaa A Nyazee, Deborah S Yokoe
1Washington University School of Medicine, St. Louis, Missouri, USA.
Objective:
To assess Clostridium difficile infection (CDI)-related colectomy rates by CDI surveillance definitions and over time at multiple healthcare facilities.
Setting:
Five university-affiliated acute care hospitals in the United States.
Design And Methods:
Cases of CDI and patients who underwent colectomy from July 2000 through June 2006 were identified from 5 US tertiary care centers. Monthly CDI-related colectomy rates were calculated as the number of CDI-related colectomies per 1,000 CDI cases, and cases were categorized according to recommended surveillance definitions. Logistic regression was performed to evaluate risk factors for CDI-related colectomy.
Results:
In total, 8,569 cases of CDI were identified, and 75 patients underwent CDI-related colectomy. The overall colectomy rate was 8.7 per 1,000 CDI cases. The CDI-related colectomy rate ranged from 0 to 23 per 1,000 CDI episodes across hospitals. The colectomy rate for healthcare-facility-onset CDI was 4.3 per 1,000 CDI cases, and that for community-onset CDI was 16.5 per 1,000 CDI cases (P < .05). There were significantly more CDI-related colectomies at hospitals B and C (P < .05).
Conclusions:
The overall CDI-related colectomy rate was low, and there was no significant change in the CDI-related colectomy rate over time. Onset of disease outside the study hospital was an independent risk factor for colectomy.
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