Comparison of national operative mortality in gastroenterological surgery using web-based prospective data entry systems

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

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

International collaboration is important in healthcare quality evaluation; however, few international comparisons of general surgery outcomes have been accomplished. Furthermore, predictive model application for risk stratification has not been internationally evaluated. The National Clinical Database (NCD) in Japan was developed in collaboration with the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP), with a goal of creating a standardized surgery database for quality improvement. The study aimed to compare the consistency and impact of risk factors of 3 major gastroenterological surgical procedures in Japan and the United States (US) using web-based prospective data entry systems: right hemicolectomy (RH), low anterior resection (LAR), and pancreaticoduodenectomy (PD). Data from NCD and ACS-NSQIP, collected over 2 years, were examined. Logistic regression models were used for predicting 30-day mortality for both countries. Models were exchanged and evaluated to determine whether the models built for one population were accurate for the other population. We obtained data for 113,980 patients; 50,501 (Japan: 34,638; US: 15,863), 42,770 (Japan: 35,445; US: 7325), and 20,709 (Japan: 15,527; US: 5182) underwent RH, LAR, and, PD, respectively. Thirty-day mortality rates for RH were 0.76% (Japan) and 1.88% (US); rates for LAR were 0.43% versus 1.08%; and rates for PD were 1.35% versus 2.57%. Patient background, comorbidities, and practice style were different between Japan and the US. In the models, the odds ratio for each variable was similar between NCD and ACSNSQIP. Local risk models could predict mortality using local data, but could not accurately predict mortality using data from other countries. We demonstrated the feasibility and efficacy of the international collaborative research between Japan and the US, but found that local risk models remain essential for quality improvement.

Original languageEnglish
Article numbere2194
JournalMedicine (United States)
Volume94
Issue number49
DOIs
Publication statusPublished - Jan 1 2015

Fingerprint

Information Systems
Japan
Mortality
Quality Improvement
Pancreaticoduodenectomy
Databases
Logistic Models
Quality of Health Care
Population
Comorbidity
Odds Ratio
Research

All Science Journal Classification (ASJC) codes

  • Medicine(all)

Cite this

Comparison of national operative mortality in gastroenterological surgery using web-based prospective data entry systems. / Anazawa, Takayuki; Paruch, Jennifer L.; Miyata, Hiroaki; Gotoh, Mitsukazu; Ko, Clifford Y.; Cohen, Mark E.; Hirahara, Norimichi; Zhou, Lynn; Konno, Hiroyuki; Wakabayashi, Go; Sugihara, Kenichi; Mori, Masaki.

In: Medicine (United States), Vol. 94, No. 49, e2194, 01.01.2015.

Research output: Contribution to journalArticle

Anazawa, T, Paruch, JL, Miyata, H, Gotoh, M, Ko, CY, Cohen, ME, Hirahara, N, Zhou, L, Konno, H, Wakabayashi, G, Sugihara, K & Mori, M 2015, 'Comparison of national operative mortality in gastroenterological surgery using web-based prospective data entry systems', Medicine (United States), vol. 94, no. 49, e2194. https://doi.org/10.1097/MD.0000000000002194
Anazawa, Takayuki ; Paruch, Jennifer L. ; Miyata, Hiroaki ; Gotoh, Mitsukazu ; Ko, Clifford Y. ; Cohen, Mark E. ; Hirahara, Norimichi ; Zhou, Lynn ; Konno, Hiroyuki ; Wakabayashi, Go ; Sugihara, Kenichi ; Mori, Masaki. / Comparison of national operative mortality in gastroenterological surgery using web-based prospective data entry systems. In: Medicine (United States). 2015 ; Vol. 94, No. 49.
@article{75fc045d52594739940c610b4d6c6cef,
title = "Comparison of national operative mortality in gastroenterological surgery using web-based prospective data entry systems",
abstract = "International collaboration is important in healthcare quality evaluation; however, few international comparisons of general surgery outcomes have been accomplished. Furthermore, predictive model application for risk stratification has not been internationally evaluated. The National Clinical Database (NCD) in Japan was developed in collaboration with the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP), with a goal of creating a standardized surgery database for quality improvement. The study aimed to compare the consistency and impact of risk factors of 3 major gastroenterological surgical procedures in Japan and the United States (US) using web-based prospective data entry systems: right hemicolectomy (RH), low anterior resection (LAR), and pancreaticoduodenectomy (PD). Data from NCD and ACS-NSQIP, collected over 2 years, were examined. Logistic regression models were used for predicting 30-day mortality for both countries. Models were exchanged and evaluated to determine whether the models built for one population were accurate for the other population. We obtained data for 113,980 patients; 50,501 (Japan: 34,638; US: 15,863), 42,770 (Japan: 35,445; US: 7325), and 20,709 (Japan: 15,527; US: 5182) underwent RH, LAR, and, PD, respectively. Thirty-day mortality rates for RH were 0.76{\%} (Japan) and 1.88{\%} (US); rates for LAR were 0.43{\%} versus 1.08{\%}; and rates for PD were 1.35{\%} versus 2.57{\%}. Patient background, comorbidities, and practice style were different between Japan and the US. In the models, the odds ratio for each variable was similar between NCD and ACSNSQIP. Local risk models could predict mortality using local data, but could not accurately predict mortality using data from other countries. We demonstrated the feasibility and efficacy of the international collaborative research between Japan and the US, but found that local risk models remain essential for quality improvement.",
author = "Takayuki Anazawa and Paruch, {Jennifer L.} and Hiroaki Miyata and Mitsukazu Gotoh and Ko, {Clifford Y.} and Cohen, {Mark E.} and Norimichi Hirahara and Lynn Zhou and Hiroyuki Konno and Go Wakabayashi and Kenichi Sugihara and Masaki Mori",
year = "2015",
month = "1",
day = "1",
doi = "10.1097/MD.0000000000002194",
language = "English",
volume = "94",
journal = "Medicine; analytical reviews of general medicine, neurology, psychiatry, dermatology, and pediatries",
issn = "0025-7974",
publisher = "Lippincott Williams and Wilkins",
number = "49",

}

TY - JOUR

T1 - Comparison of national operative mortality in gastroenterological surgery using web-based prospective data entry systems

AU - Anazawa, Takayuki

AU - Paruch, Jennifer L.

AU - Miyata, Hiroaki

AU - Gotoh, Mitsukazu

AU - Ko, Clifford Y.

AU - Cohen, Mark E.

AU - Hirahara, Norimichi

AU - Zhou, Lynn

AU - Konno, Hiroyuki

AU - Wakabayashi, Go

AU - Sugihara, Kenichi

AU - Mori, Masaki

PY - 2015/1/1

Y1 - 2015/1/1

N2 - International collaboration is important in healthcare quality evaluation; however, few international comparisons of general surgery outcomes have been accomplished. Furthermore, predictive model application for risk stratification has not been internationally evaluated. The National Clinical Database (NCD) in Japan was developed in collaboration with the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP), with a goal of creating a standardized surgery database for quality improvement. The study aimed to compare the consistency and impact of risk factors of 3 major gastroenterological surgical procedures in Japan and the United States (US) using web-based prospective data entry systems: right hemicolectomy (RH), low anterior resection (LAR), and pancreaticoduodenectomy (PD). Data from NCD and ACS-NSQIP, collected over 2 years, were examined. Logistic regression models were used for predicting 30-day mortality for both countries. Models were exchanged and evaluated to determine whether the models built for one population were accurate for the other population. We obtained data for 113,980 patients; 50,501 (Japan: 34,638; US: 15,863), 42,770 (Japan: 35,445; US: 7325), and 20,709 (Japan: 15,527; US: 5182) underwent RH, LAR, and, PD, respectively. Thirty-day mortality rates for RH were 0.76% (Japan) and 1.88% (US); rates for LAR were 0.43% versus 1.08%; and rates for PD were 1.35% versus 2.57%. Patient background, comorbidities, and practice style were different between Japan and the US. In the models, the odds ratio for each variable was similar between NCD and ACSNSQIP. Local risk models could predict mortality using local data, but could not accurately predict mortality using data from other countries. We demonstrated the feasibility and efficacy of the international collaborative research between Japan and the US, but found that local risk models remain essential for quality improvement.

AB - International collaboration is important in healthcare quality evaluation; however, few international comparisons of general surgery outcomes have been accomplished. Furthermore, predictive model application for risk stratification has not been internationally evaluated. The National Clinical Database (NCD) in Japan was developed in collaboration with the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP), with a goal of creating a standardized surgery database for quality improvement. The study aimed to compare the consistency and impact of risk factors of 3 major gastroenterological surgical procedures in Japan and the United States (US) using web-based prospective data entry systems: right hemicolectomy (RH), low anterior resection (LAR), and pancreaticoduodenectomy (PD). Data from NCD and ACS-NSQIP, collected over 2 years, were examined. Logistic regression models were used for predicting 30-day mortality for both countries. Models were exchanged and evaluated to determine whether the models built for one population were accurate for the other population. We obtained data for 113,980 patients; 50,501 (Japan: 34,638; US: 15,863), 42,770 (Japan: 35,445; US: 7325), and 20,709 (Japan: 15,527; US: 5182) underwent RH, LAR, and, PD, respectively. Thirty-day mortality rates for RH were 0.76% (Japan) and 1.88% (US); rates for LAR were 0.43% versus 1.08%; and rates for PD were 1.35% versus 2.57%. Patient background, comorbidities, and practice style were different between Japan and the US. In the models, the odds ratio for each variable was similar between NCD and ACSNSQIP. Local risk models could predict mortality using local data, but could not accurately predict mortality using data from other countries. We demonstrated the feasibility and efficacy of the international collaborative research between Japan and the US, but found that local risk models remain essential for quality improvement.

UR - http://www.scopus.com/inward/record.url?scp=84952666173&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84952666173&partnerID=8YFLogxK

U2 - 10.1097/MD.0000000000002194

DO - 10.1097/MD.0000000000002194

M3 - Article

C2 - 26656350

AN - SCOPUS:84952666173

VL - 94

JO - Medicine; analytical reviews of general medicine, neurology, psychiatry, dermatology, and pediatries

JF - Medicine; analytical reviews of general medicine, neurology, psychiatry, dermatology, and pediatries

SN - 0025-7974

IS - 49

M1 - e2194

ER -