Abstract
Background The incidence of Clostridium difficile infection is increasing in the United States. The aim of our investigation is to compare short-term and long-term outcomes of patients admitted with an ulcerative colitis (UC) flare and co-existent C. difficile infection to those of non-infected patients. Methods A historical cohort study was undertaken examining admissions at Mount Sinai Hospital between June 2004 and June 2005 using ICD-9 criteria for UC. Charts were abstracted for those patients for whom C. difficile testing was performed. Results Of 288 admissions, 99 charts met the inclusion criteria. Fifty-two patients were C. difficile-negative and 47 were positive. Demographic data and laboratory values upon admission did not differ between the two groups. Patients who were C. difficile-positive had significantly more UC-related hospitalizations and emergency room visits in the year following initial admission (58 visits vs. 27, P = 0.001 and eight visits vs. 1 visit (P = 0.012), respectively). One year following the index admission, C. difficile patients had significantly higher rates of colectomy compared to C. difficile-negative patients (44.6% vs. 25%, P = 0.04). Length of hospitalization (11.7 vs. 11 days), use of cyclosporine therapy during index admission (48% vs. 47% of patients), and percentage requiring colectomy at initial admission (23.4% vs. 13.5%) did not reach statistical significance. Conclusions Our data suggest that patients presenting with a UC flare who are infected with C. difficile have worse long-term clinical outcomes than those that are C. difficile-negative. C. difficile testing should be performed for all patients presenting with UC flare. Further studies are warranted to elucidate how infection can alter the natural history of UC.
| Original language | English |
|---|---|
| Pages (from-to) | 415-420 |
| Number of pages | 6 |
| Journal | Digestive Diseases and Sciences |
| Volume | 55 |
| Issue number | 2 |
| DOIs | |
| State | Published - Feb 1 2010 |
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Keywords
- Clostridium difficile
- Inflammatory bowel disease
- Ulcerative colitis
ASJC Scopus subject areas
- Gastroenterology
- Physiology
Cite this
Clinical outcomes of patients with ulcerative colitis and co-existing clostridium difficile infection. / Jodorkovsky, Daniela; Young, Yuki; Abreu, Maria T.
In: Digestive Diseases and Sciences, Vol. 55, No. 2, 01.02.2010, p. 415-420.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Clinical outcomes of patients with ulcerative colitis and co-existing clostridium difficile infection
AU - Jodorkovsky, Daniela
AU - Young, Yuki
AU - Abreu, Maria T
PY - 2010/2/1
Y1 - 2010/2/1
N2 - Background The incidence of Clostridium difficile infection is increasing in the United States. The aim of our investigation is to compare short-term and long-term outcomes of patients admitted with an ulcerative colitis (UC) flare and co-existent C. difficile infection to those of non-infected patients. Methods A historical cohort study was undertaken examining admissions at Mount Sinai Hospital between June 2004 and June 2005 using ICD-9 criteria for UC. Charts were abstracted for those patients for whom C. difficile testing was performed. Results Of 288 admissions, 99 charts met the inclusion criteria. Fifty-two patients were C. difficile-negative and 47 were positive. Demographic data and laboratory values upon admission did not differ between the two groups. Patients who were C. difficile-positive had significantly more UC-related hospitalizations and emergency room visits in the year following initial admission (58 visits vs. 27, P = 0.001 and eight visits vs. 1 visit (P = 0.012), respectively). One year following the index admission, C. difficile patients had significantly higher rates of colectomy compared to C. difficile-negative patients (44.6% vs. 25%, P = 0.04). Length of hospitalization (11.7 vs. 11 days), use of cyclosporine therapy during index admission (48% vs. 47% of patients), and percentage requiring colectomy at initial admission (23.4% vs. 13.5%) did not reach statistical significance. Conclusions Our data suggest that patients presenting with a UC flare who are infected with C. difficile have worse long-term clinical outcomes than those that are C. difficile-negative. C. difficile testing should be performed for all patients presenting with UC flare. Further studies are warranted to elucidate how infection can alter the natural history of UC.
AB - Background The incidence of Clostridium difficile infection is increasing in the United States. The aim of our investigation is to compare short-term and long-term outcomes of patients admitted with an ulcerative colitis (UC) flare and co-existent C. difficile infection to those of non-infected patients. Methods A historical cohort study was undertaken examining admissions at Mount Sinai Hospital between June 2004 and June 2005 using ICD-9 criteria for UC. Charts were abstracted for those patients for whom C. difficile testing was performed. Results Of 288 admissions, 99 charts met the inclusion criteria. Fifty-two patients were C. difficile-negative and 47 were positive. Demographic data and laboratory values upon admission did not differ between the two groups. Patients who were C. difficile-positive had significantly more UC-related hospitalizations and emergency room visits in the year following initial admission (58 visits vs. 27, P = 0.001 and eight visits vs. 1 visit (P = 0.012), respectively). One year following the index admission, C. difficile patients had significantly higher rates of colectomy compared to C. difficile-negative patients (44.6% vs. 25%, P = 0.04). Length of hospitalization (11.7 vs. 11 days), use of cyclosporine therapy during index admission (48% vs. 47% of patients), and percentage requiring colectomy at initial admission (23.4% vs. 13.5%) did not reach statistical significance. Conclusions Our data suggest that patients presenting with a UC flare who are infected with C. difficile have worse long-term clinical outcomes than those that are C. difficile-negative. C. difficile testing should be performed for all patients presenting with UC flare. Further studies are warranted to elucidate how infection can alter the natural history of UC.
KW - Clostridium difficile
KW - Inflammatory bowel disease
KW - Ulcerative colitis
UR - http://www.scopus.com/inward/record.url?scp=76849114352&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=76849114352&partnerID=8YFLogxK
U2 - 10.1007/s10620-009-0749-9
DO - 10.1007/s10620-009-0749-9
M3 - Article
C2 - 19255850
AN - SCOPUS:76849114352
VL - 55
SP - 415
EP - 420
JO - Digestive Diseases and Sciences
JF - Digestive Diseases and Sciences
SN - 0163-2116
IS - 2
ER -