A risk model for esophagectomy using data of 5354 patients included in a Japanese nationwide web-based database

Hiroya Takeuchi, Hiroaki Miyata, Mitsukazu Gotoh, Yuko Kitagawa, Hideo Baba, Wataru Kimura, Naohiro Tomita, Tohru Nakagoe, Mitsuo Shimada, Kenichi Sugihara, Masaki Mori

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Abstract

Objective: This study aimed to create a risk model of mortality associated with esophagectomy using a Japanese nationwide database. Methods: A total of 5354 patients who underwent esophagectomy in 713 hospitals in 2011 were evaluated. Variables and definitions were virtually identical to those adopted by the American College of Surgeons National Surgical Quality Improvement Program. Results: The mean patient age was 65.9 years, and 84.3% patients were male. The overall morbidity ratewas 41.9%. Thirty-day and operative mortality rates after esophagectomywere 1.2% and 3.4%, respectively. Overall morbiditywas significantly higher in the minimally invasive esophagectomy group than in the open esophagectomy group (44.3% vs 40.8%, P = 0.016). The odds ratios for 30-day mortality in patients who required preoperative assistance in activities of daily living (ADL), those with a history of smoking within 1 year before surgery, and those with weight loss more than 10% within 6months before surgery were 4.2, 2.6, and 2.4, respectively. The odds ratios for operative mortality in patients who required preoperative assistance in ADL, those with metastasis/relapse, male patients, and those with chronic obstructive pulmonary disease were 4.7, 4.5, 2.3, and 2.1, respectively. Conclusions: This study was the first, as per our knowledge, to perform risk stratification for esophagectomy using a Japanese nationwide database. The 30-day and operative mortality rates were relatively lower than those in previous reports. The risk models developed in this study may contribute toward improvements in quality control of procedures and creation of a novel scoring system.

Original languageEnglish
Pages (from-to)259-266
Number of pages8
JournalAnnals of surgery
Volume260
Issue number2
DOIs
Publication statusPublished - 2014 Aug

Keywords

  • 30-day mortality
  • Esophageal cancer
  • Esophagectomy
  • Minimally invasive esophagectomy
  • Operative mortality
  • Thoracoscopic surgery

ASJC Scopus subject areas

  • Surgery

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    Takeuchi, H., Miyata, H., Gotoh, M., Kitagawa, Y., Baba, H., Kimura, W., Tomita, N., Nakagoe, T., Shimada, M., Sugihara, K., & Mori, M. (2014). A risk model for esophagectomy using data of 5354 patients included in a Japanese nationwide web-based database. Annals of surgery, 260(2), 259-266. https://doi.org/10.1097/SLA.0000000000000644