Long-term follow-up of patients with fulminant Clostridium difficile colitis.
OBJECTIVE
The purpose of this study was to determine the long-term survival rate, rate of gastrointestinal continuity restoration, and rate of recurrence following an attack of fulminant Clostridium difficile colitis.


METHODS
Fulminant C. difficile colitis was defined as any patient who had a bout of C. difficile colitis and required surgical intervention after failing medical therapy. These patients were found through a pathological database search. Follow-up phone calls were made to any patient who survived at least 30 days after being discharged from the hospital following surgical intervention (long-term survivor group).


RESULTS
A total of 49 patients were involved in the study. The 30-day mortality rate was 57% (28/49), with an in-hospital mortality rate of 49%. The 5-year survival rate for the long-term survival group was 38% (8/21) and 16.3% for all patients. Gastrointestinal continuity was restored in 20% of the patients. There was one documented recurrence of C. difficile colitis


CONCLUSIONS
Patients who have a bout of fulminant C. difficile colitis have a poor prognosis of surviving longer than 5 years. Restoring gastrointestinal continuity is uncommon and usually reserved for patients with few co-morbidities. Recurrent C. difficile colitis after surgical resection is a rare occurrence.
Miller
Aaron T
AT
Department of Surgery, Mount Sinai School of Medicine, 5 E. 98th Street, 15th Floor, Box 1259, New York, NY 10029, USA.
Tabrizian
Parissa
P
Greenstein
Alexander J
AJ
Dikman
Andrew
A
Byrn
John
J
Divino
Celia
C
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D016360:Clostridioides difficile; D003082:Colectomy; D003125:Colostomy; D018572:Disease-Free Survival; D004761:Enterocolitis, Pseudomembranous / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007081:Ileostomy; D008297:Male; D008875:Middle Aged; D015996:Survival Rate; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents