Outcome after colectomy for Clostridium difficile colitis
Outcome after colectomy for Clostridium difficile colitis
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DOI：
10.1007/s10350-004-0672-2
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发表时间：
2004-10-01
影响因子：
3.9
通讯作者：
Johnson, FE
中科院分区：
文献类型：
--
作者：
Longo, WE;Mazuski, JE;Johnson, FE
艰难梭菌结肠炎是一种相对常见的疾病，但大量暴发性艰难梭菌结肠炎患者的报道却很少。本研究旨在确定因暴发性艰难梭菌结肠炎而需要结肠切除术的患者的危险因素、临床特征和结果。方法：对 1997 年至 2001 年退伍军人事务部 159 家医院的所有患者进行了一项基于人群的研究。数据是根据退伍军人事务部的几个国家计算机化数据集编制的。从当地医疗记录中获得了补充信息，包括人口统计信息、出院摘要、手术报告和病理报告。将患者变量输入计算机数据库并使用皮尔逊卡方检验和费舍尔精确检验进行分析。统计显着性指定为 P < 0.05。结果：确定了 67 名患者（平均年龄 69 岁（范围 40-86）；99% 为男性）。所有 67 名患者的结肠切除标本中均检测到艰难梭菌。 67 名患者中有 36 名 (54%) 在因不相关疾病住院期间患上艰难梭菌结肠炎，36 名患者中有 30 名 (7%) 在手术后患上艰难梭菌结肠炎。 67 人中有 31 人（46%）在家中患上了艰难梭菌结肠炎。 67 名患者中有 25 名（37%）没有腹泻病史。 67 名患者中有 30 名 (45%) 出现休克症状（血压、血压、
Clostridium difficile colitis is a relatively common entity, yet large series of patients with fulminant C difficile colitis are infrequently reported. This study was designed to identify risk factors, clinical characteristics, and outcome of patients who required colectomy for fulminant C difficile colitis. METHODS: A population-based study on all patients in 159 hospitals of the Department of Veterans Affairs from 1997 to 2001 was performed. Data were compiled from several national computerized Department of Veterans Affairs data sets. Supplementary information including demographic information, discharge summaries, operative reports, and pathology reports were obtained from local medical records. Patient variables were entered into a computerized database and analyzed using the Pearson chi-squared and Fisher's exact tests. Statistical significance was designated as P < 0.05. RESULTS: Sixty-seven patients (mean age, 69 (range, 40-86) years; 99 percent males) were identified. All 67 patients had C difficile verified in the colectomy specimens. Thirty-six of 67 patients (54 percent) developed C difficile colitis during a hospitalization for an unrelated illness, and 30 of 36 patients ( 7 percent) after a surgical procedure. Thirty-one of 67 (46 percent) developed C difficile colitis at home. There was no history of diarrhea in 25 of 67 patients (37 percent). Thirty of 67 patients (45 percent) presented in shock (blood pressure,