ArticleClinical orthopaedics and related research2013
Clostridium difficile colitis in patients undergoing lower-extremity arthroplasty: rare infection with major impact.
Article in Clinical orthopaedics and related research, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 2 of them syntheses that pooled it.
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Who cites it
9 citing papers in PubMed, 2 syntheses or guidelines pooled it, 29 citations in OpenAlex.
- Incidence and Outcomes Associated With Clostridium difficile Infections: A Systematic Review and Meta-analysis.JAMA network open · 2020Pooled it
- Cost of hospital management of Clostridium difficile infection in United States-a meta-analysis and modelling study.BMC infectious diseases · 2016Pooled it
- Gastrointestinal complications after fast-track total hip and knee replacement: an observational study in a consecutive 36,932 patient cohort.Archives of orthopaedic and trauma surgery · 2023Observational
- Clostridium difficile infection in the USA: incidence and associated factors in revision total knee arthroplasty patients.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2019Article
- How Common-and How Serious- Is Clostridium difficile Colitis After Geriatric Hip Fracture? Findings from the NSQIP Dataset.Clinical orthopaedics and related research · 2018Article
- Management of a cluster ofAntimicrobial resistance and infection control · 2017Article
- The Burden of Clostridium difficile after Cervical Spine Surgery.Global spine journal · 2016Article
- Clostridium difficile-associated diarrhoea in primary joint arthroplasty in Aneurin Bevan University Health Board South.Annals of the Royal College of Surgeons of England · 2016Article
- Patient volumes and pre- and postdischarge postpartum infection: A retrospective cohort study.American journal of infection control · 2016Article
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Authors and funding
4 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe prevalence of Clostridium difficile colitis is reportedly increasing in surgical patients and can negatively impact their outcome. However, as yet there are no clear estimates of the C difficile infection colitis rate and its consequences among patients undergoing total joint arthroplasty (TJA). QUESTIONS/PURPOSES: We asked: (1) What is the rate of C difficile colitis in TJA patients? (2) What are the risk factors of C difficile colitis in these patients? And (3) what is the effect of C difficile colitis on length of stay, in-hospital mortality, and estimated total charges?
methodsUsing ICD-9-CM diagnosis and procedure codes, we queried the Nationwide Inpatient Sample database for patients undergoing TJA for the years 2002 to 2010. Demographic data, comorbidities, occurrence of C difficile colitis, length of hospital stay, mortality, and hospital charges were extracted. Logistic regression was performed to identify predictors of C difficile colitis and its impact on in-hospital mortality.
resultsThe incidence of C difficile remained less than 0.6% during the study period. Revision TJAs (odds ratio=6.9 and 4.4 for hip and knee, respectively) and number of comorbidities (odds ratio=1.5) increased risk of C difficile colitis. C difficile increased length of hospital stay by a week, hospital charges by USD 40,000, and in-hospital mortality to 4.66% from 0.24%.
conclusionsUsing lower and fewer doses of antibiotics in revision TJAs and among patients with many comorbidities may diminish risk of C difficile colitis and its consequent mortality. LEVEL OF EVIDENCE: Level II, prognostic study. See Instructions for Authors for a complete description of levels of evidence.
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