Predictors of Mortality After Colectomy for Fulminant Clostridium difficile Colitis

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Abstract
The incidence and severity of Clostridium difficile infection is reaching epidemic proportions.1,2 The often self-limiting infection can evolve into a fulminant process ending with toxic megacolon in susceptible hosts for unclear reasons.3-6 Patients with fulminant infection require surgery in up to 20% of cases, carrying a mortality of 35% to 80%.7-9 Studies of the surgical management of C difficile infection have been limited by small sample size and the lack of a standard definition of fulminancy and further confounded by population-specific immunocompromise. We present, to our knowledge, the largest single-institution experience over a 12-year period with colectomy for fulminant C difficile colitis and propose factors significant in predicting mortality.