Risk factors of surgical mortality in patients with Clostridium difficile colitis. A novel scoring system

Ahmed, Nasim; Kuo, Yen-Hong; Guinto, Robyn K; Purewal, Jordan

doi:10.1007/s00068-021-01769-y

Cited by 2 publications

(2 citation statements)

References 22 publications

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“…Several scoring systems have been developed to predict the severity of CDI, but none of them have been validated ( Barbut and Rupnik, 2012 ; Kassam et al, 2016 ; Ahmed et al, 2021 ), and there is still no consensus indicator that can be used to differentiate disease severity ( Bauer et al, 2012 ; Surawicz et al, 2013 ; Debast et al, 2014 ; McDonald et al, 2018 ). The SOFA score is a widely accepted predictive model for patients with infectious diseases.…”

Section: Discussionmentioning

confidence: 99%

Risk Factors of Severe Clostridioides difficile Infection; Sequential Organ Failure Assessment Score, Antibiotics, and Ribotypes

et al. 2022

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We aimed to determine whether the Sequential Organ Failure Assessment (SOFA) score predicts the prognosis of patients with Clostridioides difficile infection (CDI). In addition, the association between the type of antibiotic used and PCR ribotypes was analyzed. We conducted a propensity score (PS)-matched study and machine learning analysis using clinical data from all adult patients with confirmed CDI in three South Korean hospitals. A total of 5,337 adult patients with CDI were included in this study, and 828 (15.5%) were classified as having severe CDI. The top variables selected by the machine learning models were maximum body temperature, platelet count, eosinophil count, oxygen saturation, Glasgow Coma Scale, serum albumin, and respiratory rate. After propensity score-matching, the SOFA score, white blood cell (WBC) count, serum albumin level, and ventilator use were significantly associated with severe CDI (P < 0.001 for all). The log-rank test of SOFA score ≥ 4 significantly differentiated severe CDI patients from the non-severe group. The use of fluoroquinolone was more related to CDI patients with ribotype 018 strains than to ribotype 014/020 (P < 0.001). Even after controlling for other variables using propensity score matching analysis, we found that the SOFA score was a clinical predictor of severe CDI. We also demonstrated that the use of fluoroquinolones in hospital settings could be associated with the PCR ribotype in patients with CDI.

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Section: Discussionmentioning

confidence: 99%

Risk Factors of Severe Clostridioides difficile Infection; Sequential Organ Failure Assessment Score, Antibiotics, and Ribotypes

et al. 2022

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“…While there is no widely used and validated scoring system, patients with the following tend to have higher mortality after emergency colectomy for fulminant C. difficile colitis: shock requiring vasopressors, respiratory failure requiring mechanical ventilation, electrolyte derangement, renal failure, chronic steroid use, and/or advanced age (>75 years old). 53,54,[59][60][61] The timing of surgery is critically important. Therefore, it is essential to obtain an early surgical consultation so that the patient can receive a lifesaving operation before requiring vasopressors for shock and development of multiorgan failure.…”

Section: Surgical Managementmentioning

confidence: 99%

Management of Severe Colitis and Toxic Megacolon

Liggett,

Alam

2023

Clin Colon Rectal Surg

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Severe colitis is a well-defined condition encompassing several etiologies but is most often caused by severe ulcerative colitis or Clostridioides difficile infection. Severe colitis can evolve into toxic colitis, or toxic megacolon when associated with bowel dilation and systemic manifestations, resulting in a life-threatening scenario where multidisciplinary management is often required. Medical management continues to play an important role in the initial treatment of toxic megacolon. However, timely surgical intervention can be lifesaving.

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Risk factors of surgical mortality in patients with Clostridium difficile colitis. A novel scoring system

Cited by 2 publications

References 22 publications

Risk Factors of Severe Clostridioides difficile Infection; Sequential Organ Failure Assessment Score, Antibiotics, and Ribotypes

Risk Factors of Severe Clostridioides difficile Infection; Sequential Organ Failure Assessment Score, Antibiotics, and Ribotypes

Management of Severe Colitis and Toxic Megacolon

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