1
40
1
-
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
URL Address
<a href="http://doi.org/10.1097/TA.0000000000000232" target="_blank" rel="noreferrer noopener">http://doi.org/10.1097/TA.0000000000000232</a>
Pages
1484–1493
Issue
6
Volume
76
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
Timing and type of surgical treatment of Clostridium difficile-associated disease: a practice management guideline from the Eastern Association for the Surgery of Trauma.
Publisher
An entity responsible for making the resource available
The journal of trauma and acute care surgery
Date
A point or period of time associated with an event in the lifecycle of the resource
2014
2014-06
Subject
The topic of the resource
*Clostridium difficile; *Practice Guidelines as Topic; *Societies; *Traumatology; Clostridium Difficile; Clostridium Infections – Epidemiology; Clostridium Infections – Microbiology; Clostridium Infections – Surgery; Clostridium Infections/epidemiology/microbiology/*surgery; Cross Infection – Epidemiology; Cross Infection – Microbiology; Cross Infection – Surgery; Cross Infection/epidemiology/microbiology/*surgery; Human; Humans; Incidence; Medical; Medical Organizations; Meta Analysis; Operative Time; Practice Guidelines; Survival – Trends; Survival Rate/trends; Systematic Review; Time Factors; Traumatology; United States; United States/epidemiology
Creator
An entity primarily responsible for making the resource
Ferrada Paula; Velopulos Catherine G; Sultan Shahnaz; Haut Elliott R; Johnson Emily; Praba-Egge Anita; Enniss Toby; Dorion Heath; Martin Niels D; Bosarge Patrick; Rushing Amy; Duane Therese M
Description
An account of the resource
BACKGROUND: Clostridium difficile infection is the leading cause of nosocomial diarrhea in the United States; however, few patients will develop fulminant C. difficile-associated disease (CDAD), necessitating an urgent operative intervention. Mortality for patients who require operative intervention is very high, up to 80% in some series. Since there is no consensus in the literature regarding the best operative treatment for this disease, we sought to answer the following:PICO [population, intervention, comparison, and outcome] Question 1: In adult patients with CDAD, does early surgery compared with late surgery, as defined by the need for vasopressors, decrease mortality?PICO Question 2: In adult patients with CDAD, does total abdominal colectomy (TAC) compared with other types of surgical intervention decrease mortality? METHODS: A subcommittee of the Practice Management Guideline Committee of the Eastern Association for the Surgery of Trauma conducted a systematic review and meta-analysis for the selected questions. RevMan software was used to generate forest plots. Grading of Recommendations, Assessment, Development and Evaluations methodology was used to rate the quality of the evidence, using GRADEpro software to create evidence tables. RESULTS: Reduction in mortality was significantly associated with early surgery, with a risk ratio (RR) of 0.5 (95% confidence interval [CI], 0.35-0.72). The quality of evidence was rated "moderate." Considering only the first procedure performed, mortality seemed to trend higher for TAC, with an RR of 1.11 (95% CI, 0.69-1.80). Considering only the actual procedure performed, the point estimate switched sides, showing a trend toward decreased mortality with TAC (RR, 0.86; 95% CI, 0.56-1.31). The quality of evidence was rated "very low." CONCLUSION: We strongly recommend that adult patients with CDAD undergo early surgery, before the development of shock and need for vasopressors. We conditionally recommend total or subtotal colectomy (vs. partial colectomy or other surgery) when the diagnosis of The Centers for Disease Control and Prevention is known.
Identifier
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.1097/TA.0000000000000232" target="_blank" rel="noreferrer noopener">10.1097/TA.0000000000000232</a>
Rights
Information about rights held in and over the resource
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
*Clostridium difficile
*Practice Guidelines as Topic
*Societies
*Traumatology
2014
Bosarge Patrick
Clostridium difficile
Clostridium Infections – Epidemiology
Clostridium Infections – Microbiology
Clostridium Infections – Surgery
Clostridium Infections/epidemiology/microbiology/*surgery
Cross Infection – Epidemiology
Cross Infection – Microbiology
Cross Infection – Surgery
Cross Infection/epidemiology/microbiology/*surgery
Dorion Heath
Duane Therese M
Enniss Toby
Ferrada Paula
Haut Elliott R
Human
Humans
Incidence
Johnson Emily
Martin Niels D
Medical
Medical Organizations
Meta Analysis
Operative Time
Praba-Egge Anita
Practice Guidelines
Rushing Amy
Sultan Shahnaz
Survival – Trends
Survival Rate/trends
systematic review
The journal of trauma and acute care surgery
Time Factors
Traumatology
United States
United States/epidemiology
Velopulos Catherine G