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Risk Factors of Vondran et al for Fulminant Clostridium difficile Infection After Cardiac Surgery

Description

Vondran et al identified risk factors for fulminant Clostridium difficile infection in patients undergoing cardiac surgery. These can help to identify a patient who may benefit from more aggressive management. The authors are from Heart Center Leipzig, University Hospital Marburg, Center of Cardiovascular Diseases Rotenburg and the University of Leipzig.


Patient selection: cardiac surgery with post-operative diarrhea due to C. difficile

 

Outcome: fulminant Clostridium difficile colitis

 

Risk factors with odds ratios 3,4 to 3.5:

(1) pre-operative mechanical ventilation

(2) FFP > 5 units

 

Risk factors with odds ratios 1.7 to 2.0:

(1) diabetes mellitus type 2

(2) cross-clamp time > 130 minutes

(3) red blood cell transfusion > 8 units

 

The 30-day mortality was 22% for fulminant Clostridium difficile vs 4% for others.

 

It might be interesting to know what percent of patients showed evidence of ischemic colitis since the patients are at risk for peripheral artery disease, hypotension and hypoxia.


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