Markelov et al reported factors associated with mortality following colectomy for fulminant Clostridium difficile colitis. The authors are from Easton Hospital and Drexel University in Philadelphia.
Patient selection: status post colectomy for fulminant C. difficile colitis
Predictors of mortality:
(1) signs of hemodynamic instability (heart rate > 115 bpm; mean arterial pressure < 65 mm Hg)
(2) marked leukocytosis (WBC count > 34,600 per µL)
(3) hypoalbuminemia (serum albumin < 1.5 g/dL)
(4) septic shock with need for cardiorespiratory support (mechanical ventilation and/or vasopressors)
The conclusion was that early surgery prior to the onset of organ failure(s) would be associated with better outcomes.
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