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Meta-Analysis
. 2023 Sep;68(9):3714-3720.
doi: 10.1007/s10620-023-07998-y. Epub 2023 Jul 5.

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

Yassin Shams Eldien Naga  1 , Banreet Singh Dhindsa  2 , Jay Bapaye  3 , Kyaw Min Tun  4 , Amaninder Dhaliwal  5 , Daryl Ramai  6 , Syed Mohsin Saghir  7 , Saurabh Chandan  7 , Douglas G Adler  8
Affiliations
Meta-Analysis

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

Yassin Shams Eldien Naga et al. Dig Dis Sci. 2023 Sep.

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.

Keywords: Appendectomy; Clostridioides difficile; Meta-analysis; Severity.

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