Journal of Gastrointestinal Surgery

, Volume 16, Issue 8, pp 1566–1572 | Cite as

Chemotherapy Patients with C. difficile Colitis Have Outcomes Similar to Immunocompetent C. difficile Patients

  • David B. Stewart
  • Emmanuel Yacoub
  • Junjia Zhu
Original Article



Clostridium difficile colitis (CDC) patients receiving chemotherapy for hematologic malignancies are anticipated to have worse outcomes than immunocompetent CDC patients.

Study design

An IRB approved retrospective cohort study (2004–2009) identified an equal number (n = 49) of CDC inpatients receiving chemotherapy for hematologic malignancies (CDC-HM) as well as CDC patients without malignancies (CDC-NM). Chi-squared tests, linear regression, and analysis of variance were used to compare outcomes.


No difference (p > 0.05) was noted between groups regarding age, hypertension, diabetes, COPD, or coronary artery disease. Approximately 62 % of CDC-HM patients required colony-stimulating factor for neutropenia. There was no difference (p > 0.05) in peak lactate or creatinine levels. None of the CDC-HM group required colectomy, while four CDC-NM patients required surgery (p = 0.04); neither group experienced death. No differences were noted regarding need for ICU admission for CDC or the need for vasopressors (p > 0.05). Mean hospital length of stay was longer for the CDC-HM group (22 days vs. 10 days; p = 0.001).


CDC-HM patients had longer lengths of stay than CDC-NM patients without an increase in rates of death, colectomy, or ICU admission. Outcomes in CDC-HM are better than many would anticipate, underscoring the current knowledge deficit regarding C. difficile infection.


Clostridium difficile Colitis Chemotherapy Colectomy Immunosuppression Immunocompetent 


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Copyright information

© The Society for Surgery of the Alimentary Tract 2012

Authors and Affiliations

  • David B. Stewart
    • 1
    • 2
  • Emmanuel Yacoub
    • 1
  • Junjia Zhu
    • 1
  1. 1.Department of Surgery, Division of Colorectal SurgeryThe Pennsylvania State University, College of MedicineHersheyUSA
  2. 2.Department of SurgeryPenn State College of MedicineHersheyUSA

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