C. L. Charlton1, D. Chen1, V. Pandit1, A. Cruz1, D. Sessinou1, P. Vij1, V. Nfonsam1 1University Of Arizona,Department Of Surgery,Tucson, AZ, USA
Introduction:
Colon resections and ostomies are commonly performed surgical procedures. Clostridium difficile (C. diff) is a known disease process associated with worse outcomes but variations exists among patients developing C. diff. The aim of the study was to assess the prevalence of C. diff among patient with colon resection with primary anastomosis (CR), ileostomy (IS), and colostomy (CS).
Methods:
We queried the National Impatient Sample (NIS) for the year 2011 selecting patients with age ≥ 18. Patients were stratified into: large-large colon resection with primary anastomosis (CR), small-large colon resection with primary anastomosis (IR), ileostomy (IS), and colostomy (CS). The primary outcome measure was development of C. diff infection. Statistical analysis was performed.
Results:
A total of 6,013,105 patients were assessed of which 20,312 patients were included. 49.6% had CR, 21.9% had IS and 24.7% had CS. Patients with CS (OR: 1.4, p=1.43×10^-6) were more likely to develop C. diff compared to patients with CR, while patients with IS (OR: 0.74, p=0.52) were less likely to develop C. diff compared to patients with IR. On comparing CS to IS, patients with CS were more likely to develop C. diff (OR: 1.8, p=3.62×10^-8). There was no difference in developing C. diff between ostomy reversal and colon resection.
Conclusion:
Patients with colostomy or large colon resection were more likely to develop C. diff than patients with ileostomies or small intestine resection. However, there did not appear to be any difference between the rates of C. diff infection when comparing whether a patient has ostomy reversal or a colon resection.