Warning: Undefined variable $zfal in C:\Inetpub\vhosts\kidney.de\httpdocs\mlpefetch.php on line 525
Deprecated: str_replace(): Passing null to parameter #3 ($subject) of type array|string is deprecated in C:\Inetpub\vhosts\kidney.de\httpdocs\mlpefetch.php on line 525
Warning: Undefined variable $sterm in C:\Inetpub\vhosts\kidney.de\httpdocs\mlpefetch.php on line 530
Warning: Undefined variable $sterm in C:\Inetpub\vhosts\kidney.de\httpdocs\mlpefetch.php on line 531
English Wikipedia
Nephropedia Template TP (
Twit Text
DeepDyve Pubget Overpricing |
lüll Predictors of mortality after colectomy for fulminant Clostridium difficile colitis Byrn JC; Maun DC; Gingold DS; Baril DT; Ozao JJ; Divino CMArch Surg 2008[Feb]; 143 (2): 150-4; discussion 155OBJECTIVES: To present, to our knowledge, the largest experience with colectomy for fulminant Clostridium difficile colitis and to propose factors significant in predicting mortality. DESIGN: Retrospective medical record review. SETTING: University teaching hospital. PATIENTS: Seventy-three patients undergoing colectomy between 1994 and 2005 for C difficile-associated pseudomembranous colitis. MAIN OUTCOME MEASURES: Preoperative predictors of in-hospital mortality. RESULTS: Seventy-three of 5718 cases (1.3%) of C difficile colitis required colectomy. Mean age was 68 years. In-hospital mortality was 34% (n = 25). Eighty-six percent (n = 63) of patients received a subtotal colectomy. Patients presented with diarrhea (84%; n = 61), abdominal pain (75%; n = 55), and ileus (16%; n = 12). Mean duration of symptoms was 7 days followed by 4 days of medical treatment prior to colectomy. On univariate analysis, an admitting diagnosis other than C difficile (P = .049), vasopressor requirement (P = .001), intubation (P = .001), and mental status changes (P < .001) were significant predictors of mortality. Arterial lactate level (4.9 vs 2.4 mmol/L; P = .007) was significantly higher and length of medical management (6.4 vs 3.0 days; P = .006) was significantly longer in the mortality group. Platelet counts (169 x 10(3)/microL vs 261 x 10(3)/microL [to convert to x 10(9)/L, multiply by 1]; P = .04) were significantly lower in the mortality group. On multivariate analysis, vasopressor requirement (P = .04; odds ratio, 5.0), mental status changes (P = .002; odds ratio, 12.6), and treatment length (P = .002; odds ratio, 1.4) remained significant predictors of mortality. CONCLUSIONS: Colectomy for C difficile colitis carries a substantial mortality regardless of patient age and white blood cell count. Preoperative vasopressor requirement, mental status changes, and length of medical treatment significantly predict mortality.|Aged[MESH]|Aged, 80 and over[MESH]|Analysis of Variance[MESH]|Bacteremia/diagnosis/mortality/surgery[MESH]|Cause of Death[MESH]|Clostridioides difficile/*pathogenicity[MESH]|Clostridium Infections/diagnosis/*mortality/*surgery[MESH]|Colectomy/adverse effects/methods[MESH]|Enterocolitis, Pseudomembranous/microbiology/*mortality/*surgery[MESH]|Female[MESH]|Follow-Up Studies[MESH]|Hospital Mortality/trends[MESH]|Hospitals, University[MESH]|Humans[MESH]|Male[MESH]|Middle Aged[MESH]|Multivariate Analysis[MESH]|Odds Ratio[MESH]|Predictive Value of Tests[MESH]|Probability[MESH]|Registries[MESH]|Retrospective Studies[MESH]|Risk Assessment[MESH]|Survival Analysis[MESH] |