Open AccessTiming and type of surgical treatment of Clostridium difficile–associated disease
Author(s) -
Paula Ferrada,
Catherine G. Velopulos,
Shahnaz Sultan,
Elliott R. Haut,
Emily M. Johnson,
Anita Praba-Egge,
Toby M. Enniss,
Heath A. Dorion,
Niels D. Martin,
Patrick Bosarge,
Amy Rushing,
Therèse M. Duane
Publication year - 2014
Publication title -
the journal of trauma and acute care surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.25
H-Index - 187
eISSN - 2163-0763
pISSN - 2163-0755
DOI - 10.1097/ta.0000000000000232
Subject(s) - medicine , guideline , clostridium difficile , grading (engineering) , mortality rate , disease , confidence interval , population , fulminant , meta analysis , intensive care medicine , surgery , environmental health , pathology , civil engineering , microbiology and biotechnology , biology , engineering , antibiotics
Clostridium difficile infection is the leading cause of nosocomial diarrhea in the United States; however, few patients will develop fulminant C. difficile-associated disease (CDAD), necessitating an urgent operative intervention. Mortality for patients who require operative intervention is very high, up to 80% in some series. Since there is no consensus in the literature regarding the best operative treatment for this disease, we sought to answer the following:PICO [population, intervention, comparison, and outcome] Question 1: In adult patients with CDAD, does early surgery compared with late surgery, as defined by the need for vasopressors, decrease mortality?PICO Question 2: In adult patients with CDAD, does total abdominal colectomy (TAC) compared with other types of surgical intervention decrease mortality?