Clostridium difficile infection (CDI) is a common complication of inflammatory bowel diseases (IBDs) and is associated with worse outcome.
Variable rates of colectomy have been reported among IBD complicated by CDI.
Dr Yingxi Chen and colleagues conducted a systematic review and meta-analysis of studies to assess the association between CDI and colectomy among patients with IBD.
The literature was systematically searched using PubMed from inception through 2016.
|Clostridium difficile doubled the odds for colectomy among patients with IBD|
|Inflammatory Bowel Diseases|
Studies were limited to cohort, case–control, and cross-sectional studies reporting colectomy risk stratified by CDI in patients with IBD.
The researchers estimated summary odds ratio and 95% CIs using the quality-effects model.
Study quality was assessed using an adaptation of the Newcastle–Ottawa scale.
The research team identified 6 studies in the meta-analysis, comprising 8 data sets.
The researchers showed that CDI was a significant risk factor for colectomy among patients with IBD, mainly patients with ulcerative colitis, almost doubling the odds.
The team found significant heterogeneity across studies.
Funnel plots were grossly asymmetrical.
Results of sensitivity analysis restricting studies to those reporting ulcerative colitis only and studies using laboratory tests to confirm CDI were consistent with the result from the main analysis.
Dr Chen's team comments, "CDI is a significant risk factor for colectomy in patients with IBD."
"Further research is needed to investigate the attributable risks of surgery due to CDI among patients with Crohn's disease."