Tohru Nakagoe1, Hiroaki Miyata1,2, Mitsukazu Gotoh3,4,5, Takayuki Anazawa6, Hideo Baba1, Wataru Kimura1, Naohiro Tomita1, Mitsuo Shimada1, Yuko Kitagawa1, Kenichi Sugihara6, Masaki Mori6. 1. The Japanese Society of Gastroenterological Surgery, Database Committee, Tokyo, Japan. 2. National Clinical Database (NCD), Tokyo, Japan. 3. The Japanese Society of Gastroenterological Surgery, Database Committee, Tokyo, Japan. mgotoh@fmu.ac.jp. 4. National Clinical Database (NCD), Tokyo, Japan. mgotoh@fmu.ac.jp. 5. Department of Regenerative Surgery, Fukushima Medical University, 1 Hikarigaoka, Fukushima, 960-1295, Japan. mgotoh@fmu.ac.jp. 6. The Japanese Society of Gastroenterological Surgery, Tokyo, Japan.
Abstract
PURPOSE: Acute diffuse peritonitis (ADP) is an important surgical complication associated with high morbidity and mortality; however, the risk factors associated with a poor outcome have remained controversial. This study aimed in collecting integrated data using a web-based national database system to build a risk model for mortality after surgery for ADP. METHODS: We included cases registered in the National Clinical Database in Japan. After data cleanup, 8,482 surgical cases of ADP from 1,285 hospitals treated between January 1 and December 31, 2011 were analyzed. RESULTS: The raw 30-day and surgical mortality rates were 9.0 and 14.1 %, respectively. The odds ratios (>2.0) for 30-day mortality were as follows: American Society of Anesthesiologists (ASA) class 3, 2.69; ASA class 4, 4.28; ASA class 5, 8.65; previous percutaneous coronary intervention (PCI), 2.05; previous surgery for peripheral vascular disease (PVD), 2.45 and disseminated cancer, 2.16. The odds ratios (>2.0) for surgical mortality were as follows: ASA class 3, 2.27; ASA class 4, 4.67; ASA class 5, 6.54, and disseminated cancer, 2.09. The C-indices of 30-day and surgical mortality were 0.851 and 0.852, respectively. CONCLUSION: This is the first report of risk stratification after surgery for ADP using a nationwide surgical database. This system could be useful to predict the outcome of surgery for ADP and for evaluations and benchmark performance studies.
PURPOSE: Acute diffuse peritonitis (ADP) is an important surgical complication associated with high morbidity and mortality; however, the risk factors associated with a poor outcome have remained controversial. This study aimed in collecting integrated data using a web-based national database system to build a risk model for mortality after surgery for ADP. METHODS: We included cases registered in the National Clinical Database in Japan. After data cleanup, 8,482 surgical cases of ADP from 1,285 hospitals treated between January 1 and December 31, 2011 were analyzed. RESULTS: The raw 30-day and surgical mortality rates were 9.0 and 14.1 %, respectively. The odds ratios (>2.0) for 30-day mortality were as follows: American Society of Anesthesiologists (ASA) class 3, 2.69; ASA class 4, 4.28; ASA class 5, 8.65; previous percutaneous coronary intervention (PCI), 2.05; previous surgery for peripheral vascular disease (PVD), 2.45 and disseminated cancer, 2.16. The odds ratios (>2.0) for surgical mortality were as follows: ASA class 3, 2.27; ASA class 4, 4.67; ASA class 5, 6.54, and disseminated cancer, 2.09. The C-indices of 30-day and surgical mortality were 0.851 and 0.852, respectively. CONCLUSION: This is the first report of risk stratification after surgery for ADP using a nationwide surgical database. This system could be useful to predict the outcome of surgery for ADP and for evaluations and benchmark performance studies.
Entities:
Keywords:
Acute diffuse peritonitis; Mortality; Risk factor; Risk model
Authors: Joseph S Solomkin; John E Mazuski; John S Bradley; Keith A Rodvold; Ellie J C Goldstein; Ellen J Baron; Patrick J O'Neill; Anthony W Chow; E Patchen Dellinger; Soumitra R Eachempati; Sherwood Gorbach; Mary Hilfiker; Addison K May; Avery B Nathens; Robert G Sawyer; John G Bartlett Journal: Clin Infect Dis Date: 2010-01-15 Impact factor: 9.079
Authors: Takayuki Anazawa; Jennifer L Paruch; Hiroaki Miyata; Mitsukazu Gotoh; Clifford Y Ko; Mark E Cohen; Norimichi Hirahara; Lynn Zhou; Hiroyuki Konno; Go Wakabayashi; Kenichi Sugihara; Masaki Mori Journal: Medicine (Baltimore) Date: 2015-12 Impact factor: 1.817