Hepatology and Pancreatic Science

ISSN: 2573-4563

Open Access

Clostridium difficile infection and risk of colectomy in patients with inflammatory bowel disease: A biasadjusted meta-analysis


Yingxi Chen

Clostridium difficile Infection (CDI) may be a common complication of inflammatory bowel diseases (IBDs) and is related to worse outcome. Variable rates of colectomy are reported among IBD complicated by CDI. We conducted a scientific review and biasadjusted meta-analysis of studies to assess the association between CDI and colectomy among patients with IBD. Studies were limited to cohort, case???control and cross-sectional studies reporting colectomy risk stratified by CDI in patients with IBD. We estimated summary ORs and 95% CIs using the quality-effects model. Study quality was assessed using an adaptation of the Newcastle???Ottawa scale. We found that CDI was a major risk factor for colectomy among patients with IBD, mainly patients with colitis, almost doubling the chances (OR 1.90; 95% CI, 1.23???2.93). There was significant heterogeneity across studies (Q=22.02, P<0.001; I2=68%). Funnel plots were grossly asymmetrical. Results of sensitivity analysis restricting studies to those reporting inflammatory bowel disease only and studies using laboratory tests to substantiate CDI were in keeping with the result from the most analysis. CDI could be a significant risk factor for colectomy in patients with IBD. Further research is required to research the attributable risks of surgery thanks to CDI among patients with inflammatory bowel disease. Inflammatory bowel disease (IBD), comprising colitis (UC) and regional enteritis (CD), may be a chronic relapsing disorder of genetically susceptible individuals exposed to environmental precipitants.The initial management of IBD is medical therapy until treatment fails or a complication arises. Most patients with CD and up to 35% of patients with UC required intestinal resection during the course of their disease.However, improved medical therapy has resulted in decreased surgical interventions among patients with IBD.


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