No abstract

including length of stay, treatment, mortality, and relapses were analysed and compared to standard hospital episode statistics (HES). Results The annualised hospital incidence of CDAD was 70/20 000 admissions, age range 2e100 yrs (mean 75.5, M: F). 76.8% patients were older than 70 yrs. 43% had received antibiotics prior to admission and 35 (62%) patients were commenced on antibiotics in hospital. The top 5 were Amoxicillin, Co-amoxiclav, Flucloxacillin, Cephalexin and Trimethoprim. 62% of these had received one course of antibiotic, and 30% two or more courses. 39% patients had a previous admission to hospital in the preceding 12 weeks, 46.4% were taking a PPI and 35.7% a laxative. C difficile was confirmed by both toxin and GDH positivity in 80.4%, and by toxin positivity only in 19.6%. Total length of stay ranged from 51 days (16%). A positive diagnosis was made in 80% patients, but severity was not always recorded. Stool charts were completed in 70%, serum lactate checked in 10% and abdominal x-ray done in 30%. Only 25% patients were seen by an MDT member. 78.5% pts were treated, 30/ 44 (68%) with Metronidazole and 11/44 (25%) with Vancomycin as first line drugs. 3/44 patients received both drugs initially. 30.4% pts received #7 days, 50% upto 14 days and 19.6% $14 days treatment. All cause mortality was 25%, almost entirely in the elderly. 7% had a recurrence, all treated by Vancomycin and pulsed/tapered regimes and probiotics were used infrequently. Conclusion CDAD continues to be an important hospital acquired infection with a significant increase in hospital length of stay and high mortality rates, especially in the elderly. This study indicates that a significant proportion of CDAD may be acquired in the community. Adherence to national recommendations for management and involvement of the MDT needs to be encouraged to improve outcomes. Introduction Management of patients with locally advanced (LA) and locally recurrent (LR) colorectal cancer is challenging, with patients frequently requiring complex multimodality interventions. Despite increasing emphasis on evaluation of health related quality of life (HRQoL) in patients having complex interventions, HRQoL information on patients with LA and LR colorectal cancer is sparse. The aim of this study was to prospectively assess outcome measures and HRQoL in a cohort of patients with LA and LR colorectal cancer at our institution. Methods LA disease was defined as tumour requiring extended multi-visceral resection in the abdomen or pelvis to achieve an R0 resection. 45 consecutive patients were prospectively assessed over a 2-year period. Demographic, treatment, and cancer-related outcomes were recorded on all patients. Pelvic disease was staged using Leeds and Royal Marsden Hospital classification systems. HRQoL was prospectively evaluated using the EORTC generic and disease specific instruments QLQ-CR30 and QLQ-CR29.Results Median age was 69 (range 46e89) and 60% were male (27/ 45). There were 25 cases of LA disease and 20 LR cases. 35 patients underwent ...

poster prompts can be used to serve as a point of reference. ESS should routinely be incorporated into departmental induction and education.