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- W2921226392 abstract "Introduction: C. difficile infection (CDI) is the most common cause of nosocomial diarrhea. Post-op patients (pts) have a distinctly increased risk of CDI and outcomes of such CDI are being actively investigated. We aimed to examine the time from surgery to first post-op CDI (i.e. index CDI) and to assess outcomes of post-op CDI among 3 major surgical categories, Gastrointestinal (GI), Vascular (Vasc), and Orthopedic (Ortho). Methods: We performed a retrospective study of pts who had surgery in one of 3 categories (GI, Ortho, and Vasc) and who developed CDI within 90 days of surgery. GI subgroups (intestinal [small intestine and colon], non-intestinal hollow viscera [stomach and gallbladder], and solid organ) were also analyzed. Pt characteristics between time of surgery and CDI were compared using ANOVA (for continuous variables) and Chi-squared test (for categorical variables). CDI recurrence rates were compared between groups using a Chi-squared test. Time from surgery to index CDI, all-cause mortality, and mortality related to CDI complications within 90 days after index CDI were analyzed using Kaplan-Meier curves and log-rank tests. Statistical significance was set at P<0.05. Results: We included 518 post-surgical pts (GI, n=187; Vasc, n=192; Ortho, n=139). Pts were older in Ortho and Vasc groups than in the GI group (Table 1). Compared with GI and Ortho, Vasc pts were more likely to be diabetic, have renal disease, and be immunocompromised at index CDI time. Compared with GI and Vasc, recent use of PPIs was less likely in Ortho pts. Use of antibiotics in the preceding 3 months was higher in Ortho and Vasc patients compared with GI pts. GI pts developed CDI sooner than Vasc pts after surgery (P=0.01); no other pairwise difference was noted (Figure 1). Among GI subgroups, nonintestinal hollow visceral procedures were complicated by CDI sooner than were intestinal procedures (P=0.02) (Figure 2). CDI recurrence was not significantly different between groups. All-cause mortality and mortality related to complications within 90 days from index CDI were higher in Vasc pts compared with GI pts (P=0.003 and 0.0032, respectively); no other pairwise difference was noted.191_A Figure 1. Patient Demographics and Clinical Characteristics at the time of CDI191_B Figure 2. Time from surgery to index CDI among post-surgical Gastrointestinal, Orthopedic, and Vascular patientsConclusion: Pts developed CDI sooner after GI surgery, especially non-intestinal hollow visceral surgery. Pts had higher all-cause mortality and mortality from complications of CDI at 90 days after Vasc surgery compared with GI surgery. There were no differences in mortality in Ortho pts compared with Vasc and GI pts.191_C Figure 3. Time from surgery to index CDI among post-surgical Gastrointestinal subgroups" @default.
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- W2921226392 date "2018-10-01" @default.
- W2921226392 modified "2023-09-27" @default.
- W2921226392 title "Outcomes and Mortality in Post-Operative C. difficile Infection: A Single Center Study" @default.
- W2921226392 doi "https://doi.org/10.14309/00000434-201810001-00191" @default.
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