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C. Difficile Risk Higher With Stoma Reversal Versus Colectomy

Findings based on examination of 30-day postoperative period in large cohort

WEDNESDAY, April 18, 2018 (HealthDay News) — Patients who undergo elective stoma reversal have a higher incidence of postoperative Clostridium difficile infection versus patients who undergo elective colectomy, according to a study published in the May issue of Diseases of the Colon & Rectum.

Matthew Skancke, M.D., from the George Washington University Hospital in Washington, D.C., and colleagues retrospectively reviewed data from the 2015 American College of Surgeons National Surgical Quality Improvement Project and targeted colectomy database to identify 2,235 patients who underwent elective stoma reversal and 10,403 patients who underwent elective colon resection.

The researchers found that the incidence of C. difficile infection in the 30-day postoperative period was significantly higher (P < 0.001) in patients undergoing stoma reversal. Factors associated with C. difficile infection incidence in the 30-day postoperative period after controlling for other variables include stoma reversal (odds ratio, 2.701; P < 0.001), smoking (odds ratio, 1.520; P < 0.022), steroids (odds ratio, 1.677; P < 0.048), and disseminated cancer (odds ratio, 2.312; P < 0.001).

“Patients who undergo elective stoma reversal have a higher incidence of postoperative C. difficile infection compared with patients who undergo an elective colectomy,” the authors write. “Given the impact of postoperative C. difficile infection, a heightened sense of suspicion should be given to symptomatic patients after stoma reversal.”

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