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

  • Original Article
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Journal of Gastrointestinal Surgery Aims and scope

Abstract

Background

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.

Results

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).

Conclusions

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.

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Authors and Affiliations

  1. Department of Surgery, Division of Colorectal Surgery, The Pennsylvania State University, College of Medicine, Hershey, PA, USA

    David B. Stewart, Emmanuel Yacoub & Junjia Zhu

  2. Department of Surgery, Penn State College of Medicine, 500 University Drive, H137, Hershey, PA, 17033, USA

    David B. Stewart

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  1. David B. Stewart
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  2. Emmanuel Yacoub
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  3. Junjia Zhu
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Correspondence to David B. Stewart.

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Stewart, D.B., Yacoub, E. & Zhu, J. Chemotherapy Patients with C. difficile Colitis Have Outcomes Similar to Immunocompetent C. difficile Patients. J Gastrointest Surg 16, 1566–1572 (2012). https://doi.org/10.1007/s11605-012-1930-6

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  • DOI: https://doi.org/10.1007/s11605-012-1930-6

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