A Systematic Review and Meta-Analysis: A Prior Appendectomy Does Not Increase the Risk of Severe Clostridioides difficile Infection or Recurrence

Authors

Yassin Shams Eldien Naga, Department of Internal Medicine, University of South Florida Morsani College of Medicine, 12901 Bruce B Downs Blvd, Tampa, FL, 33612, USA.
Banreet Singh Dhindsa, Division of Gastroenterology and Hepatology, University of Nebraska Medical Center, Omaha, NE.
Jay Bapaye, Rochester Regional HealthFollow
Kyaw Min Tun, Department of Internal Medicine, University of Nevada Las Vegas School of Medicine, Las Vegas, NV, USA.
Amaninder Dhaliwal, Division of Gastroenterology and Hepatology, McLeod Regional Medical Center, Florence, SC, USA.
Daryl Ramai, Division of Gastroenterology and Hepatology, University of Utah School of Medicine, Salt Lake City, UT, USA.
Syed Mohsin Saghir, Division of Gastroenterology and Hepatology, Creighton University School of Medicine, Omaha, NE, USA.
Saurabh Chandan, Division of Gastroenterology and Hepatology, Creighton University School of Medicine, Omaha, NE, USA.
Douglas G. Adler, Center for Advanced Therapeutic Endoscopy, Centura Health, Denver, CO, USA.

Department

Internal Medicine

Document Type

Article

Publication Title

Digestive Diseases and Sciences

Abstract

BACKGROUND AND OBJECTIVES: There is conflicting evidence regarding the association between a prior appendectomy and severity of Clostridioides difficile infection. The aim of this study was to perform a systematic review and meta-analysis to evaluate this association.

PATIENTS AND METHODS: Comprehensive review of multiple databases was performed up to May 2022. The primary outcome assessed was the rate of severe Clostridioides difficile infection in patients with a prior appendectomy compared to patients with an appendix. The secondary outcomes assessed were recurrence, mortality, and colectomy rates associated with Clostridioides difficile infection in patients with a prior appendectomy compared to patients with an appendix.

RESULTS: Eight studies with 666 patients with a prior appendectomy and 3580 patients without an appendectomy were included. The odds ratio of severe Clostridioides difficile infection in patients who underwent prior appendectomy was 1.03 (95% CI 0.6-1.78, p = 0.92). The odds ratio of recurrence in patients who underwent prior appendectomy was 1.29 (95% CI 0.82-2.02, p = 0.28). The odds ratio of colectomy due to Clostridioides difficile infection in patients who underwent prior appendectomy was 2.16 (95% CI 1.27-3.67, p = 0.004). The odds ratio of mortality due to Clostridioides difficile infection in patients with a prior appendectomy was 0.92 (95% CI 0.62-1.37, p = 0.68).

CONCLUSION: Patients with appendectomy are not at increased risk for developing severe Clostridioides difficile infection or recurrence. Further prospective studies are needed to establish these associations.

First Page

3714

Last Page

3720

DOI

10.1007/s10620-023-07998-y

Volume

68

Issue

9

Publication Date

9-1-2023

Publisher

Springer Science + Business Media

PubMed ID

37402978

Recommended Citation

Naga, Y. S., Dhindsa, B. S., Bapaye, J., Tun, K. M., Dhaliwal, A., Ramai, D., Saghir, S. M., Chandan, S., & Adler, D. G. (2023). A Systematic Review and Meta-Analysis: A Prior Appendectomy Does Not Increase the Risk of Severe Clostridioides difficile Infection or Recurrence. Digestive Diseases and Sciences, 68 (9), 3714-3720. https://doi.org/10.1007/s10620-023-07998-y