Yingxi Chen
National Institutes of Health, USA
Posters & Accepted Abstracts: J Hepatol Gastroint Dis
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. We conducted a systematic review and bias-adjusted meta-analysis of studies to assess the association between CDI and colectomy among patients with IBD. Studies were limited to cohort, caseâ??control and cross-sectional studies reporting colectomy risk stratified by CDI in patients with IBD. We estimated summary ORs and 95% CIs using the quality-effects model. Study quality was assessed using an adaptation of the Newcastleâ??Ottawa scale. We found that CDI was a significant risk factor for colectomy among patients with IBD, mainly patients with ulcerative colitis, almost doubling the odds (OR 1.90; 95% CI, 1.23â??2.93). There was significant heterogeneity across studies (Q=22.02, P<0.001; I2=68%). 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. 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.
E-mail: yingxi.chen@anu.edu.au
