title: Efficacy of computed tomography for the prediction of colectomy and mortality in patients withclostridium difficileinfection.
abstract: OBJECTIVE
  To develop a CT predictor scale for the need for colectomy and to evaluate predictors of all-cause mortality within 30 days after diagnosis ofC. difficileinfection (CDI).
  
  
  METHODS
  We conducted a retrospective study of adult hospitalized patients whounderwent abdominal CT within 72 h of diagnosis of CDI.
  
  
  RESULTS
  Presence of abnormal wall thickening in caecum (OR 8.0; CI 1.37-46.81; p = 0.021), transverse colon (OR 6.7; CI 1.15-35.60; p = 0.034), sigmoid colon (OR 12.6; CI 1.37-115.97; p = 0.025), pancolitis (OR 7.0; CI 1.36-36.01; p = 0.02) and bowel dilation (OR 16.5; CI 2.41-112.83; p = 0.004) predicted colectomy. With these values, a five parameter radiological scale from 0 to 24 was developed (sensitivity and NPV of 100%, cut-off of 6). Furthermore, wall thickening of caecum (OR 6.2; CI 1.06-35.57; p = 0.043), ascending colon (OR 12.0; CI 1.29-111.32; p = 0.029), descending colon (OR 17.0; CI 1.81-160.05; p = 0.013) and sigmoid (OR 10.2; CI 1.10-94.10; p = 0.041) independently predicted mortality within 30 days of CDI diagnosis.
  
  
  CONCLUSIONS
  We designed a CT scale to predict colectomy, able to rule out the development of fulminant colitis and the need for surgical procedure. Patients with wall thickening of the caecum, ascending, descending or sigmoid colon were more likely to die within 30 days of CDI diagnosis.
authors.affiliation: Servicio de Infectología, Hospital Universitario Dr. José Eleuterio González, Universidad Autónoma de Nuevo León, 64460 Monterrey, NL, Mexico.
authors.forename: Laura
authors.initials: L
authors.lastname: Paláu-Dávila
authors.affiliation: Servicio de Infectología, Hospital Universitario Dr. José Eleuterio González, Universidad Autónoma de Nuevo León, 64460 Monterrey, NL, Mexico.
authors.forename: Reynaldo
authors.initials: R
authors.lastname: Lara-Medrano
authors.affiliation: Departamento de Radiología e Imagenología Hospital Universitario Dr. José Eleuterio González, Universidad Autónoma de Nuevo León, 64460 Monterrey, NL, Mexico.
authors.forename: Adrián A
authors.initials: AA
authors.lastname: Negreros-Osuna
authors.affiliation: Departamento de Radiología e Imagenología Hospital Universitario Dr. José Eleuterio González, Universidad Autónoma de Nuevo León, 64460 Monterrey, NL, Mexico.
authors.forename: Matías
authors.initials: M
authors.lastname: Salinas-Chapa
authors.affiliation: Servicio de Gastroenterología, Hospital Universitario Dr. José Eleuterio González, Universidad Autónoma de Nuevo León, 64460 Monterrey, NL, Mexico.
authors.forename: Elvira
authors.initials: E
authors.lastname: Garza-González
authors.affiliation: Servicio de Infectología, Hospital Universitario Dr. José Eleuterio González, Universidad Autónoma de Nuevo León, 64460 Monterrey, NL, Mexico.
authors.forename: Eva Marìa
authors.initials: EM
authors.lastname: Gutierrez-Delgado
authors.affiliation: Coordinación de Epidemiología Hospitalaria, Hospital Universitario Dr. José Eleuterio González, Universidad Autónoma de Nuevo León, 64460 Monterrey, NL, Mexico.
authors.forename: Adrián
authors.initials: A
authors.lastname: Camacho-Ortiz
keywords: Abdominal CT scan; Clostridium difficile; Colectomy; Nosocomial infection; Prediction score