Introduction: Obesity is a known risk factor for Clostridioides difficile infection (CDI). Bariatric surgery is widely used to manage obesity in a certain patient population, but bariatric surgery significantly reduces stomach acid production, and gastric acid suppression has been deemed to be another risk factor for CDI. However, there is little data on the outcomes of CDI in patients who had bariatric surgery. Thus, we aim to assess the outcomes of CDI in patients with a history of bariatric surgery.
Methods: Patients hospitalized with CDI from the National Inpatient Sample (NIS) database 2014 were selected. Diagnoses were identified by using ICD-9 CM codes. Patient demographics and outcomes of CDI were compared between the groups with and without a history of bariatric surgery. The outcomes of interest were inpatient mortality, length of stay, total hospital charge, hypotension/shock, acute renal failure, ileus, megacolon, and colectomy. Chi-squared tests and independent t-tests were used to compare proportions and means, respectively. Multivariate logistic regression analysis was performed to determine if bariatric surgery is an independent predictor of the outcomes, adjusting for age, sex, race, Charlson Comorbidity Index, and obesity.
Results: There were no statistically significant differences in length of stay, total hospital charge, and inpatient mortality between the groups. After adjusting for age, sex, race, Charlson Comorbidity Index, and obesity, there were no statistically significant differences in outcomes of interest, including hypotension/shock, acute renal failure, ileus, megacolon, and colectomy.
Discussion: Our study indicates that a history of bariatric surgery has no significant impact on the outcomes of CDI among hospitalized patients despite potential physiologic changes with bariatric surgery.
