DLI Is Safe Alternative in Patients With Fulminant C difficile Colitis

Objective: To determine if diverting loop ileostomy (DLI) with antegrade colonic lavage is associated with better outcomes compared to total abdominal colectomy (TAC) for fulminant Clostridioides difficile colitis. Design: Retrospective study. Methods: A 10-year retrospective review was conducted of the National Inpatient Sample database, which includes data on approximately 7 million hospitalizations per year in the United States. Patients were matched on age, gender, race, comorbidities, illness severity, risk of mortality, insurance, hospital characteristics, vasopressor use, immunosuppressant use, and presence of ileus. After matching those patients who had a similar propensity for undergoing either DLI or TAC outcomes were compared based on whether they actually underwent DLI or TAC. Results: After matching, there were 668 patients in each group, and they were well matched in terms of demographics, illness severity, vasopressor or immunosuppressant use, hospital characteristics, more...