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Is partial colectomy the operation of choice in pediatric Clostridium difficile colitis?

Justin Lee1, David B Tashjian, Kevin P Moriarty

  • 1Baystate Children's Hospital, Tufts University School of Medicine, Springfield, MA 01199, USA. Justin.Lee@tufts.edu

Pediatric Surgery International
|May 1, 2012
PubMed

Insights

Pediatric hospitalizations for Clostridium difficile colitis (CDC) are increasing. Partial colectomy is more common than total colectomy and shows similar outcomes for mortality, length of stay, and hospital charges.

Area of Science:

  • Pediatric Surgery
  • Gastroenterology
  • Infectious Diseases

Background:

  • Clostridium difficile colitis (CDC) is a significant cause of pediatric hospitalizations.
  • Understanding national trends in pediatric CDC incidence and surgical management is crucial.

Purpose of the Study:

  • To examine national trends in the incidence of pediatric Clostridium difficile colitis (CDC) hospitalizations.
  • To analyze the surgical management strategies employed for pediatric CDC.

Main Methods:

  • Cross-sectional analysis of the Nationwide Inpatient Sample (NIS) database from 2000 to 2008.
  • Inclusion of patient demographics, surgical procedures, length of stay (LOS), total hospital charges (THC), and in-hospital mortality data.
  • Statistical analysis to compare outcomes between partial and total colectomy.

Main Results:

  • Pediatric CDC hospitalizations nearly doubled from 2000 to 2008, with rates increasing from 38.08 to 72.57 per 100,000 discharges.
  • Partial colectomy was more frequently performed than total colectomy (0.35% of cases).
  • No significant differences in mortality, LOS, or THC were observed between partial and total colectomy. Ulcerative colitis patients and infants <1 year showed different colectomy preferences.

Conclusions:

  • Pediatric hospitalizations for CDC are increasing, necessitating attention to management strategies.
  • Partial colectomy appears to be a safe and effective surgical approach for pediatric CDC, comparable to total colectomy in key outcomes.
  • Further research is required to establish standardized surgical guidelines for pediatric CDC.
Abstract

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