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Colitis More Common in Hospitalized Patients

According to a report in the July issue of Archives of Surgery,the rate of cases of colitis (colon inflammation) caused by the bacteria Clostridium difficile more than doubled among patients hospitalized in the United States between 1993 and 2003, and the illness was more severe and associated with an increased mortality rate.

C. difficile inhabits the intestines of approximately 1 percent to 3 percent of healthy adults and about 20 percent of patients receiving antibiotics, according to background information in the article.

When the balance of bacteria in the colon is altered, C. difficile can cause a variety of symptoms, including severe or complicated diarrhea that may eventually lead to death. Treatment for life-threatening forms of the disease usually involves colectomy, or removal of all or part of the colon, which is associated with a high rate of complications and high mortality.

Three million new cases of C. difficile colitis occur in the United States each year: as many as 10 percent of patients hospitalized for at least two days are affected, the authors write. Anecdotal evidence and some case series suggest that C. difficile colitis has become more common and potentially more pathogenic.

Rocco Ricciardi, M.D., M.P.H., then of the University of Minnesota Medical School, Minneapolis, and now of Lahey Clinic, Burlington. Mass., and colleagues analyzed discharge data from a database of U.S. hospitals between 1993 and 2003.

The database, the Nationwide Inpatient Sample, includes data from about 7 million hospital stays per year in 1,000 hospitals located in 35 states; thus, it approximates a 20 percent stratified sample of U.S. community hospitals, the authors write.

It provides information on patient demographics, socioeconomic factors, admission profiles, hospital profiles, state codes, discharge diagnoses, procedure codes, total charges and vital status at hospital discharge.

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