The Total Abdominal Colectomy (TAC) is the recommended procedure for Fulminant Clostridium Difficile Colitis (FCDC), however, occasionally, FCDC is also treated with partial colectomies. The purpose of the study was to identify the outcomes of partial colectomy in FCDC cases. The National Surgical Quality Improvement Program database was accessed and eligible patients from 2012 through 2016 were reviewed. Patients 18 years and older who were diagnosed with FCDC and who underwent colectomies were included in the study. Patients’ demography, clinical characteristics, comorbidities, mortality, morbidities, length of hospital stay and discharge disposition were compared between the group who underwent partial colectomy and the group who underwent TAC. Univariate analysis followed by propensity matching was performed. A P value of < 0.05 is considered as statistically significant. Out of 491 patients who qualified for the study, 93 (18.9%) patients underwent partial colectomy. The pair matched analysis showed no significant difference in patients’ characteristics and comorbidities in the two groups. There was no significant difference found in mortality between the two groups (30.1% vs. 30.1%, P > 0.99). There were no differences found in the median [95% CI] hospital length of stay (LOS) (23 days [19–31] vs. 21 [17–25], P = 0.30), post-operative complications (all P > 0.05), and discharged disposition to home ( 33.8% vs. 43.1%) or transfer to rehab (21.55 vs. 12.3%, P = 0.357) between the TAC and partial colectomy groups. The overall 30 days mortality remains very high in FCDC. Partial colectomy did not increase risk of mortality or morbidities and LOS. Level IV. Observational cohort.

中文翻译：

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暴发性艰难梭菌结肠炎全结肠切除术与部分结肠切除术的结果：倾向匹配分析

腹腔全结肠切除术 (TAC) 是暴发性艰难梭菌结肠炎 (FCDC) 的推荐手术，然而，有时 FCDC 也接受部分结肠切除术治疗。该研究的目的是确定 FCDC 病例中部分结肠切除术的结果。访问了国家手术质量改进计划数据库，并审查了 2012 年至 2016 年符合条件的患者。被诊断患有 FCDC 并接受结肠切除术的 18 岁及以上的患者被纳入研究。比较结肠部分切除术组和TAC组患者的人口统计学、临床特征、合并症、死亡率、发病率、住院时间和出院情况。进行单变量分析，然后进行倾向匹配。AP 值 < 0。05 被认为具有统计学意义。在符合研究条件的 491 名患者中，93 名（18.9%）患者接受了部分结肠切除术。配对分析显示，两组患者的特征和合并症无显着差异。两组死亡率无显着差异（30.1% vs. 30.1%，P>0.99）。中位数 [95% CI] 住院时间 (LOS)（23 天 [19-31] 与 21 [17-25]，P = 0.30）、术后并发症（所有 P > 0.05），出院处置回家（33.8% 对 43.1%）或转移到康复中心（21.55 对 12.3%，P = 0.357）在 TAC 和部分结肠切除术组之间。FCDC 的总体 30 天死亡率仍然很高。部分结肠切除术不会增加死亡率或发病率和 LOS 的风险。第四级。