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Predictors of Mortality After Colectomy for Fulminant Clostridium difficile Colitis—Invited Critique
Marcia L. McGory, MD;
Clifford Y. Ko, MD, MS, MSHS
Arch Surg. 2008;143(2):155.
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Fulminant C difficile colitis is an increasing surgical disease. Byrn et al performed a single-institution retrospective review of 73 C difficile colitis cases requiring colectomy from 1994 to 2005. The main research finding was identification of vasopressor requirement, mental status changes, and treatment length as independent mortality predictors.
In contrast to previous retrospective reviews of colectomy for C difficile colitis using only descriptive statistics, Byrn et al identify associations of in-hospital mortality using multivariate regression. These findings contribute to our clinical understanding of this disease; however, we should recognize potential limitations. First, the small sample size of 73 patients may limit the ability of Byrn et al to identify additional significant results. For example, some nonsignificant mortality predictors may actually predict mortality but generate nonsignificant P values because of the small study cohort (ie, type II error). Second, Byrn et . . . [Full Text of this Article]
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Predictors of Mortality After Colectomy for Fulminant Clostridium difficile Colitis
John C. Byrn, Dipen C. Maun, Daniel S. Gingold, Donald T. Baril, Junko J. Ozao, and Celia M. Divino
Arch Surg. 2008;143(2):150-154.
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