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Risk factors for clostridium difficile infection in general surgery patients

Published:September 21, 2022DOI:https://doi.org/10.1016/j.amjsurg.2022.09.031

      Highlights

      • General surgery patients are at increased risk for clostridium difficile infection.
      • Emergent surgery and infection are risk factors for clostridium difficile.
      • Longer time prior to surgery is a risk factor for clostridium difficile.
      • Laparoscopic surgery may be a protective factor for clostridium difficile.

      Abstract

      Background

      Clostridium Difficile Infection (CDI) is a significant cause of mortality. This study aims to identify predictors of CDI in general surgery patients.

      Methods

      Patients who underwent general surgery operations in the 2019 National Surgical Quality Improvement Program database were identified with demographic, intervention, and outcome data abstracted. Patients with CDI and no CDI were compared by univariate analysis. Multivariable logistic regression (MLR) was performed to determine independent predictors of CDI.

      Results

      Of 436,831 surgical patients, 1,840 patients were diagnosed with CDI (0.4%). Patients with CDI have a higher mortality (2.1% vs 0.76%,p < 0.0001), longer length of stay (7 days vs 1 day, p < 0.0001), and are less likely to undergo a laparoscopic procedure (29.9% vs 37.5%, p < 0.0001). MLR identified older age, emergent operation, increased time to operation, surgical site infection, deep organ space infection, steroid use, metastatic cancer, smoking, and decreased body mass index (BMI) as independent predictors of CDI.

      Conclusions

      CDI is rare following general surgery. Infections, delay to operation, and emergency operations are associated with CDI.

      Keywords

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