[Skip to Content]
Access to paid content on this site is currently suspended due to excessive activity being detected from your IP address Please contact the publisher to request reinstatement.
[Skip to Content Landing]
Research Letter
Association of VA Surgeons
January 2016

Increasing Incidence of and Increased Mortality Associated With Clostridium difficile–Associated Megacolon

Author Affiliations
  • 1Surgical Service, The Center for Innovations in Quality, Outcomes, and Patient Safety, Overton Brooks Veterans Affairs Medical Center, Shreveport, Louisiana
  • 2Department of Surgery, Louisiana State University School of Medicine, Shreveport
  • 3Regenstrief Institute, Division of Trauma and Surgical Critical Care, Department of Surgery, University of Indiana, Indianapolis
  • 4Department of Surgery, Louisiana State University School of Medicine, Shreveport
  • 5Wound Care Center, University General Hospital, Houston, Texas
JAMA Surg. 2016;151(1):85-86. doi:10.1001/jamasurg.2015.2677

The symptoms of Clostridium difficile infection range from diarrhea to the rare, but potentially fatal, toxic megacolon. The aim of this study is to determine the changes in the incidence and outcomes of C difficile–associated megacolon over a 10-year period.

Using the Nationwide Inpatient Sample (2000-2010) and International Classification of Diseases, Ninth Revision (ICD-9) codes, we identified patients with both C difficile infection and megacolon. Patients without both diagnoses were excluded. The study cohort included patients who were managed with surgery and those who were managed without surgery. This study used deidentified data and is exempt from institutional review board approval. The outcome measures were length of stay, inflation-adjusted cost of hospitalization, transitional care needs, and in-hospital mortality.1 Analyses were performed with χ2 tests and analysis of variance. P > .05 was considered statistically significant.