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Massachusetts Chapter of the American College of Surgeons Massachusetts Chapter of the American College of Surgeons Massachusetts Chapter of the American College of Surgeons Massachusetts Chapter of the American College of Surgeons Massachusetts Chapter of the American College of Surgeons
57th Annual Meeting Abstracts


Poster 19

Abstract Title

Incidence and Outcomes of Pseudomembranous Colitis. Analysis of the NIS 2005-2007

 

Author Block

Haisar Dao, MD1, Nathan Narasimhan, MD1, Reza Kermani, MD1, Peter Lee, MD1, Akshay Raizada, MD2, Kevin O’Donnell, MD, FACS1, Alan Hackford, M.D, FACS1

1St. Elizabeth's Medical Center. TuftsUniversity School of Medicine,Boston, MA  2Kaiser Permanente Medical Center,San Francisco, CA

 

 

Abstract Body

Background: Clostridium difficile colitis has become significant problem among healthcare facilities in the United States. Our objective is to analyze the incidence of this disease among inpatients and describe current disparities in outcomes. Methods: Analysis of the Nationwide Inpatient Sample (NIS) was performed for the years 2005-2007. This database incorporates 100% of all hospital discharges from a 20% stratified sample of US hospitals. Diagnosis and procedures were identified using ICD-9 codes. Primary outcomes were in-hospital mortality and need for surgical intervention. Demographics, insurance status and hospital type were analyzed.

Results: 173,549 patients were diagnosed with pseudomembranous colitis. Mean age 69 ± 19.47 years (Female 59%). Emergency admissions represented 86% of the sample. Mean length of stay was 11.74 ± 13.68 days. Most patients were insured (98%) and received treatment in non-teaching facilities (77%). Overall mortality was 8%. Total abdominal colectomy was reported in 682 patients (0.4%). Patients who underwent surgery had higher mortality rates (p< 0.0001, odds ratio [OR] 5.54, 95% confidence interval 4.63 – 6.41). Mortality among patients over 80 years old who underwent surgery was 52% (p< 0.0001, OR 6.82, 95% CI 5.06 – 9.18). Patients treated in non teaching hospitals had an increased mortality rate (p< 0.04, OR 1.07, 95% CI 1.03 – 1.11).

Conclusion: Pseudomembranous colitis is common among hospitalized patients. Surgery is seldom needed but is associated with a fivefold risk of dying on admission. Patients over 80 years old have a high mortality rate after surgery. There appears to be a relationship between hospital teaching status and mortality although the reason is unclear

 

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