title: Life after colectomy for fulminant Clostridium difficile colitis: a 7-year follow up study.
abstract: BACKGROUND
  The long-term prognosis of patients undergoing colectomy for fulminant Clostridium difficile colitis has not been well studied. The authors present 7-year survival trends in such patients.
  
  
  METHODS
  Patients were identified through a pathologic database. Medical records were reviewed and follow-up phone calls made to determine relevant patient history, longevity, and quality of life.
  
  
  RESULTS
  The 61 patients identified had mean and median survival of 18.1 and 3.2 months, respectively, and 1-year, 2-year, 5-year, and 7-year mortality of 68.5%, 79.6%, 88.9%, and 90.7%, respectively. Previous C difficile infection, hypotension, requirement of vasopressors, mental status changes, elevated arterial lactate, decreased platelet counts, intubation, and longer duration on nonoperative therapy were associated with in-hospital mortality. There were no factors correlated with long-term survival.
  
  
  CONCLUSIONS
  Patients who require colectomy for fulminant C difficile colitis have a poor prognosis with poor long-term survival and significant morbidity. Although there are several factors associated with in-hospital mortality, there were no factors correlated with long-term survival.
authors.affiliation: Department of Surgery, The Mount Sinai School of Medicine, One Gustave L. Levy Place, Box 1259, New York, NY 10029, USA.
authors.forename: Kai B
authors.initials: KB
authors.lastname: Dallas
authors.affiliation: Department of Surgery, The Mount Sinai School of Medicine, One Gustave L. Levy Place, Box 1259, New York, NY 10029, USA.
authors.forename: Audree
authors.initials: A
authors.lastname: Condren
authors.affiliation: Department of Surgery, The Mount Sinai School of Medicine, One Gustave L. Levy Place, Box 1259, New York, NY 10029, USA. Electronic address: celia.divino@mssm.edu.
authors.forename: Celia M
authors.initials: CM
authors.lastname: Divino
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016360:Clostridioides difficile; D003082:Colectomy / Q000379:methods*; D004761:Enterocolitis, Pseudomembranous / Q000453:epidemiology / Q000382:microbiology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D017052:Hospital Mortality / Q000639:trends; D006801:Humans; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D011379:Prognosis; D011788:Quality of Life; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends; D013997:Time Factors; D014481:United States / Q000453:epidemiology
keywords: Colectomy; Fulminant Clostridium difficile colitis; Prognosis; Surgery; Survival