Luke Putnam, MD, Sahil Gambhir, MD, Gabrielle Stretz, BSc, Areg Grigorian, MD, Megan T Smith, PhD, Brian R Smith, MD, Ninh T Nguyen, MD, Shaun Daly, MD. University of California Irvine Medical Center
Introduction/Objectives: Clostridium Difficile is a significant source of morbidity in hospitalized patients. Obesity and major gastrointestinal operations are known risk factors for clostridium difficile infection (CDI). Currently, there is limited data suggesting laparoscopic roux-en-Y gastric bypass (LRYGB) is also associated with an increased incidence of CDI compared to laparoscopic sleeve gastrectomy (LSG). We hypothesized the rate of CDI in the bariatric population is elevated given inherent risk factors of this patient population and that LSG may confer less risk than LRYGB.
Methods: The Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program database was queried to identify patients who underwent LSG and LRYGB between 2015 and 2016. Data was collected from each patient’s index admission. As a surrogate for the true incidence of CDI, treatment of CDI was used. Descriptive statistics and multivariable logistic regression analyses were performed to obtain odds ratios (OR) and 95% confidence intervals (CI).
Results: During the study period, 167,563 (71%) patients underwent LSG and 67,525 (29%) underwent LRYGB. The overall incidence of CDI in our study population was 0.07%. The incidence of CDI in index hospital admission in patients undergoing LSG was 0.05% compared to 0.09% in patients undergoing LYRGB. The risk of CDI during the index hospital admission in LSG patients compared to LRYGB patients was 0.64 (95% CI 0.47-0.88; p=0.006).
Conclusion: While literature reports obesity remains a risk factor for development of CDI, the overall incidence of 0.07% remains low in postoperative bariatric patients. CDI does not represent a significant source of postoperative morbidity during index admission. In bariatric patients, those undergoing LSG have a significantly decreased risk of developing CDI compared to LRYGB patients.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 95202
Program Number: P102
Presentation Session: Poster Session (Non CME)
Presentation Type: Poster
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