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These strategies rely on surgery as a salvage therapy, which may account for the poor outcomes associated with subtotal colectomy in complicated CDI, and mortality rates that range from 35 to 80 (38,39,41,42,65,72). Data reviewed in several series suggest that earlier colectomy (time from presentation to surgery) was associated with a significantly decreased mortality (40,73,74).

In an analysis of the literature from January 1989 to May 2009, earlier diagnosis and treatment with subtotal colectomy and end-ileostomy reduced mortality associated with fulminant CDI (75). One study demonstrated a trend toward decreased mortality rates in patients with fulminant disease who underwent colectomy compared with those who did ocr unit f966 option binaire (42). These investigators further showed that admission of patients with complicated CDI to a surgical service was associated with ocr unit f966 option binaire decreased mortality and a shorter mean interval from admission to operation compared with admission to a non-surgical service.

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