TY - JOUR
T1 - Certified thoracic surgeons in Japan
T2 - a national database survey on risk-adjusted mortality associated with lung resection
AU - Miyazaki, Takuro
AU - Fukuchi, Eriko
AU - Yamamoto, Hiroyuki
AU - Miyata, Hiroaki
AU - Tanaka, Fumihiro
AU - Okada, Morihito
AU - Suzuki, Kenji
AU - Yoshino, Ichiro
AU - Endo, Shunsuke
AU - Sato, Yukio
AU - Chida, Masayuki
AU - Nagayasu, Takeshi
N1 - Funding Information:
We thank all data managers and hospitals for participating in the NCD project and for their great efforts in entering the data. This study was supported by the Japan Association of Chest Surgery.
Funding Information:
Eriko Fukuchi, Hiroyuki Yamamoto, and Hiroaki Miyata are affiliated with the Department of Healthcare Quality Assessment at the University of Tokyo. The department is a social collaboration department supported by grants from the National Clinical Database, Johnson & Johnson K.K., and Nipro Co.
Publisher Copyright:
© 2021, Springer Nature Singapore Pte Ltd.
PY - 2021/8
Y1 - 2021/8
N2 - Purpose: We investigated the association between the number of certified general thoracic surgeons (GTSs) and the mortality after lung cancer surgery, based on the data from the National Clinical Database (NCD). Methods: We analyzed the characteristics and operative and postoperative data of 120,946 patients who underwent lung cancer surgery in one of the 905 hospitals in Japan. The number of GTSs in each hospital was categorized as 0, 1–2, or 3 or more. Multivariable analysis was applied to adjust the patients’ preoperative risk factors, as identified in a previous study. We calculated 95% confidence intervals (CI) for the mortality rate based on the odds ratios (ORs). Results: The patients’ characteristics were distributed almost uniformly regardless of the number of GTSs. Crude mortality according to the number of GTSs of 0, 1–2, or 3 or more was 0.9%, 0.8%, and 0.7%, respectively (p = 0.03). However, after adjustment, the ORs for 1–2 and 3 or more GTSs (reference: 0) were 0.86 (p = 0.23, 95% CI: 0.67–1.10) and 0.84 (p = 0.18, 95% CI: 0.64–1.09), respectively. The number of GTSs did not have a significant association with mortality. Similar results were observed for patients in the lobectomy cohort. Conclusion: Low surgical mortality was consistent, regardless of the number of GTSs in each hospital.
AB - Purpose: We investigated the association between the number of certified general thoracic surgeons (GTSs) and the mortality after lung cancer surgery, based on the data from the National Clinical Database (NCD). Methods: We analyzed the characteristics and operative and postoperative data of 120,946 patients who underwent lung cancer surgery in one of the 905 hospitals in Japan. The number of GTSs in each hospital was categorized as 0, 1–2, or 3 or more. Multivariable analysis was applied to adjust the patients’ preoperative risk factors, as identified in a previous study. We calculated 95% confidence intervals (CI) for the mortality rate based on the odds ratios (ORs). Results: The patients’ characteristics were distributed almost uniformly regardless of the number of GTSs. Crude mortality according to the number of GTSs of 0, 1–2, or 3 or more was 0.9%, 0.8%, and 0.7%, respectively (p = 0.03). However, after adjustment, the ORs for 1–2 and 3 or more GTSs (reference: 0) were 0.86 (p = 0.23, 95% CI: 0.67–1.10) and 0.84 (p = 0.18, 95% CI: 0.64–1.09), respectively. The number of GTSs did not have a significant association with mortality. Similar results were observed for patients in the lobectomy cohort. Conclusion: Low surgical mortality was consistent, regardless of the number of GTSs in each hospital.
KW - Certified thoracic surgeon
KW - Lung cancer
KW - Nationwide survey
KW - Surgery
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U2 - 10.1007/s00595-021-02227-3
DO - 10.1007/s00595-021-02227-3
M3 - Article
C2 - 33515364
AN - SCOPUS:85099931768
VL - 51
SP - 1268
EP - 1275
JO - Surgery Today
JF - Surgery Today
SN - 0941-1291
IS - 8
ER -