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Preoperative risk factors for postoperative Clostridium difficile infection in colectomy patients. 2013

Greta L Krapohl, and Arden M Morris, and Shijie Cai, and Michael J Englesbe, and David M Aronoff, and Darrell A Campbell, and Samantha Hendren
Michigan Surgical Quality Collaborative, University of Michigan, 2800 Plymouth Road, Building 16, Room 124, Ann Arbor, MI 48109, USA. krapohlg@med.umich.edu

BACKGROUND Wide variation among hospitals in the rate of Clostridium difficile infection (CDI) after surgery was hypothesized to be related to different prophylactic antibiotic practices. METHODS Between March 2008 and March 2010, 30-day confirmed postoperative CDI rates were prospectively collected for patients undergoing colectomy surgery at 23 hospitals participating in a collaborative quality improvement program. Preoperative variables significantly associated with CDI (P ≤ .10) in a bivariate analysis were incorporated into a logistic regression model to test for independent associations. RESULTS Among 4,936 patients, the overall rate of CDI was 1.6% (range by hospital, 0%-9%). After adjusting for patient comorbidities and hospital site, type of preoperative antibiotics used for prophylaxis was not significantly associated with CDI. Emergency surgery, low albumin, and neurologic and renal comorbidities emerged as independent preoperative predictors of CDI. CONCLUSIONS Perioperative antibiotic practices did not prove to be independently associated with CDI after colectomy surgery.

UI MeSH Term Description Entries
D008297 Male Males
D008824 Michigan State bounded on the north by the Great Lakes, on the east by Canada, on the south by Wisconsin, Indiana, and Ohio, and on the west by Lake Michigan and Wisconsin.
D011446 Prospective Studies Observation of a population for a sufficient number of persons over a sufficient number of years to generate incidence or mortality rates subsequent to the selection of the study group. Prospective Study,Studies, Prospective,Study, Prospective
D003015 Clostridium Infections Infections with bacteria of the genus CLOSTRIDIUM and closely related CLOSTRIDIOIDES species. Clostridioides Infections,Clostridioides difficile Infection,Clostridioides perfringens Food Poisoning,Clostridioides perfringens Infections,Clostridioides sordellii Infection,Clostridium difficile Infections,Clostridium sordellii Infections,Clostridium difficile Infection,Clostridium perfringens Food Poisoning,Clostridium perfringens Infections,Clostridium sordellii Infection,Infections, Clostridium,Clostridioides Infection,Clostridioides perfringens Infection,Clostridium Infection,Clostridium perfringens Infection,Infection, Clostridioides difficile,Infection, Clostridioides sordellii,Infection, Clostridium,Infection, Clostridium difficile,Infection, Clostridium sordellii
D003082 Colectomy Surgical resection of a portion of or the entire colon. Hemicolectomy,Large Bowel Resection,Colectomies,Hemicolectomies,Large Bowel Resections,Resection, Large Bowel,Resections, Large Bowel
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D012307 Risk Factors An aspect of personal behavior or lifestyle, environmental exposure, inborn or inherited characteristic, which, based on epidemiological evidence, is known to be associated with a health-related condition considered important to prevent. Health Correlates,Risk Factor Scores,Risk Scores,Social Risk Factors,Population at Risk,Populations at Risk,Correlates, Health,Factor, Risk,Factor, Social Risk,Factors, Social Risk,Risk Factor,Risk Factor Score,Risk Factor, Social,Risk Factors, Social,Risk Score,Score, Risk,Score, Risk Factor,Social Risk Factor
D015897 Comorbidity The presence of co-existing or additional diseases with reference to an initial diagnosis or with reference to the index condition that is the subject of study. Comorbidity may affect the ability of affected individuals to function and also their survival; it may be used as a prognostic indicator for length of hospital stay, cost factors, and outcome or survival.

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