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.
| Original language | English |
|---|---|
| Pages (from-to) | 1233-1243 |
| Number of pages | 11 |
| Journal | Surgery today |
| Volume | 45 |
| Issue number | 10 |
| DOIs | |
| Publication status | Published - Oct 14 2015 |
| Externally published | Yes |
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All Science Journal Classification (ASJC) codes
- Surgery
Cite this
Surgical risk model for acute diffuse peritonitis based on a Japanese nationwide database : an initial report on the surgical and 30-day mortality. / Nakagoe, Tohru; Miyata, Hiroaki; Gotoh, Mitsukazu; Anazawa, Takayuki; Baba, Hideo; Kimura, Wataru; Tomita, Naohiro; Shimada, Mitsuo; Kitagawa, Yuko; Sugihara, Kenichi; Mori, Masaki.
In: Surgery today, Vol. 45, No. 10, 14.10.2015, p. 1233-1243.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Surgical risk model for acute diffuse peritonitis based on a Japanese nationwide database
T2 - an initial report on the surgical and 30-day mortality
AU - Nakagoe, Tohru
AU - Miyata, Hiroaki
AU - Gotoh, Mitsukazu
AU - Anazawa, Takayuki
AU - Baba, Hideo
AU - Kimura, Wataru
AU - Tomita, Naohiro
AU - Shimada, Mitsuo
AU - Kitagawa, Yuko
AU - Sugihara, Kenichi
AU - Mori, Masaki
PY - 2015/10/14
Y1 - 2015/10/14
N2 - 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.
AB - 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.
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U2 - 10.1007/s00595-014-1026-x
DO - 10.1007/s00595-014-1026-x
M3 - Article
VL - 45
SP - 1233
EP - 1243
JO - Surgery Today
JF - Surgery Today
SN - 0941-1291
IS - 10
ER -