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Clostridium difficile colitis after aortic surgery

N W Bulstrode1, A W Bradbury, S Barrett

  • 1Regional Vascular Unit, Imperial College School of Medicine, St. Mary's Hospital, London, U.K.

European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery
|November 5, 1997
PubMed
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Clostridium difficile colitis (CDC) is a significant risk after aortic surgery, affecting 8.4% of patients. Prolonged prophylactic cephalosporin use is linked to its development and should be avoided.

Area of Science:

  • Vascular Surgery
  • Infectious Diseases
  • Gastroenterology

Background:

  • Clostridium difficile colitis (CDC) is a known complication following major surgery.
  • Aortic surgery carries specific risks due to patient comorbidities and surgical invasiveness.

Purpose of the Study:

  • To investigate the incidence and outcomes of Clostridium difficile colitis (CDC) in patients undergoing aortic surgery.
  • To identify risk factors and patterns associated with CDC post-aortic procedures.

Main Methods:

  • Retrospective clinical study and case-note review.
  • Analysis of 180 patients undergoing aortic surgery between September 1994 and August 1996.
  • Identification of CDC development, patient demographics, and pre-existing risk factors.

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Main Results:

  • 15 out of 180 patients (8.4%) developed CDC, with a median age of 65.
  • Common risk factors included age over 65, renal impairment, COPD, malignancy, and intensive care unit (ICU) or high dependency unit (HDU) care.
  • CDC onset occurred a median of 14 days post-operation, often following prolonged prophylactic cefuroxime administration.

Conclusions:

  • Clostridium difficile colitis (CDC) is a frequent and serious complication after aortic surgery.
  • While patient risk factors contribute, prolonged prophylactic cephalosporin use is a key factor in CDC development.
  • Avoidance of extended prophylactic cephalosporin therapy is recommended to reduce CDC incidence.