Indications for Surgery in Patients with Severe Clostridium Difficile Colitis


P (patient population)

I (intervention)

C (comparator)

O (key outcomes)

Patients with severe Clostridium difficile colitis

Surgery

No surgery

Morbidity, mortality, quality of life





Results


The overall quality of the evidence is very low. Of the articles which met the search criteria, there were no randomized controlled trials, and only one was a prospective study (Table 25.2). Note that the data in the table shows some studies which included all patients with CDC while others show patients who underwent an intervention for CDC.


Table 25.2
Summary of studies


































































































































































































































Year
Study
Design (quality)
Study size (N)
Surgery (N)
Mortality (%)

Total
TAC
Other
Overall
Surgical
Medical

2006
Koss et al. [4]
Retrospective (very low)
3472
14
9
5
–
36
–

2007
Kenneally et al. [5]
Retrospective (very low)
278
6
–
–
37
33
37

2007
Lamontagne et al. [6]
Retrospective (very low)
165
38
35
–
53
34
58

2008
Ali et al. [7]
Retrospective (very low)
36
36
28
8
–
47
–

2008
Byrn et al. [8]
Retrospective (very low)
5718
73
63
10
–
34
–

2008
Hall and Berger [9]
Retrospective (very low)
3237
36
34
2
–
36
–

2008
Hermsen et al. [10]
Retrospective (very low)
7588
13
13
–
–
46
–

2009
Chan et al. [11]
Retrospective (very low)
15
15
12
3
–
67
–

2009
Pepin et al. [12]
Retrospective (low)
130
130
124
6
–
37
–

2009
Sailhamer et al. [13]
Retrospective (low)
4796
75
69
6
35
24
45

2009
Seder et al. [14]
Retrospective (very low)
6841
69
68
1
–
42
–

2010
Al-Abed et al. [15]
Retrospective (very low)
528
20
17
3
–
40
–

2010
Dudukgian et al. [16]
Retrospective (very low)
398
14
11
3
–
36
–

2010
Gash et al. [17]
Retrospective (very low)
1398
17
16
1
–
53
–

2010
Perera et al. [18]
Retrospective (very low)
35
35
32
3
–
46
–

2011
Markelov et al. [19]
Retrospective (very low)
13
13
12
1
–
46
–

2011
Neal et al. [2]
Prospective (low)
42
42
–
42
–
19
–

2013
Halabi et al. [20]
Retrospective (low)
2,773,521
19,374
3900
–
–
31

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Jul 13, 2018 | Posted by in ABDOMINAL MEDICINE | Comments Off on Indications for Surgery in Patients with Severe Clostridium Difficile Colitis

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