Surgical Outcome in Laparoscopic Abdominal Surgical Operations with Clostridium Difficile Infection

Abstract

Introduction: Postoperative Clostridium difficile infection (CDI) has associated morbidity, but it is unknown how it impacts different operations. We sought to determine the incidence and postoperative morbidity following abdominal surgery. Method: The National Surgical Quality Improvement Program database (2015-2019) was utilized to evaluate adult (≥18 years-old) patients who developed CDI following laparoscopic abdominal operations. Univariate and multivariate analysis were performed to evaluate outcomes. Results: A total of 973 338 patients were studied and the overall incidence of CDI was .3% within 30 days of operation. Colorectal surgery had the highest incidence of CDI (1601/167 949,1.0%) with significantly longer mean length of stay (LOS) (8.0 days± 9.0, P < .01) compared to other surgical procedures. CDI patients also had a longer mean length of stay (6.6± 8.0 vs 2.1 ± 3.6 days, P < .01) and increased mortality (1.8% vs .2%, AOR: 4.64, CI: 3.45-5.67, P < .01) compared to patients without CDI. Conclusions: This national analysis demonstrates that CDI is a significant complication following abdominal surgery and is associated with increased LOS and mortality. Furthermore, laparoscopic colorectal surgery appears to have the greatest risk of CDI. Future research is needed to determine the exact cause in order to decrease the incidence of CDI by reconsidering the protocol of antibiotic use within the high-risk population.

Association of Post Operative Infectious Complications and Length of Hospital Stay with Duration of Surgeries

“…Post operative infectious complications following major surgeries have both short and long-term consequences. [1]. Surgical site infection, pneumonia, sepsis, intravascular catheter-related infections, and urinary tract infection are different postoperative infectious complications.…”

“…Surgical site infection contributes to 38% nosocomial infections in surgical patients [2]. Most studies mainly focused on mortality caused by postoperative infection and reported that survival rates were higher in patients without infectious complications as compared to those who have no infectious complications [1,2]. Bacteremia and sepsis are especially associated with increased mortality and reduced survival rates.…”