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The impact of Clostridium difficile colitis following closure of a diverting loop ileostomy: results of a matched cohort study.
MedLine Citation:
PMID:  23336347     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
AIM: Previous reports describing Clostridium difficile colitis (CDC) developing after the closure of a loop ileostomy suggests it is severe. In this study the incidence of CDC following ileostomy closure and its effect on the postoperative outcome have been studied. METHOD: Patients undergoing closure of loop ileostomy from 2004-2008 were analyzed using the Nationwide Inpatient Sample. Patients who developed postoperative CDC (n=217) were matched 10:1 to a propensity-score matched cohort of patients without CDC (n=13,245). Linear and logistic regression was used to examine the effect of CDC on hospital cost (US dollars), length of stay (LOS) and mortality rates. Population resampling was performed using nearest neighbour bootstrapping to confirm the validity of results. RESULTS: The incidence of CDC following ileostomy closure was 16/1000 patients. The mean length of stay (LOS) was 11.5 days longer among CDC patients (p<0.0001), with a greater cost of hospitalization of $21,240 (p<0.0001). There was no difference in mortality between the cohorts. CONCLUSION: CDC following ileostomy closure is an uncommon, costly and morbid complication. Patients undergoing stoma closure are at high risk for an adverse outcome if they have CDC. Should it develop they should be aggressively treated. © 2013 The Authors. Colorectal Disease © 2013 The Association of Coloproctology of Great Britain and Ireland.
Authors:
Matthew Z Wilson; Christopher S Hollenbeak; David B Stewart
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-1-22
Journal Detail:
Title:  Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland     Volume:  -     ISSN:  1463-1318     ISO Abbreviation:  Colorectal Dis     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2013-1-22     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100883611     Medline TA:  Colorectal Dis     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2013 The Authors. Colorectal Disease © 2013 The Association of Coloproctology of Great Britain and Ireland.
Affiliation:
Department of Surgery, Penn State Milton S. Hershey Medical Center, Hershey, PA.
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