Development of a model predicting the risk of eight major postoperative complications after esophagectomy based on 10 826 cases in the Japan National Clinical Database

Yu Ohkura, Hiroaki Miyata, Hiroyuki Konno, Harushi Udagawa, Masaki Ueno, Junichi Shindoh, Hiraku Kumamaru, Go Wakabayashi, Mitsukazu Gotoh, Masaki Mori

Research output: Contribution to journalArticle

Abstract

Background: Esophagectomy is a highly invasive procedure with a high incidence of complications. The objectives of this study were to create risk prediction models for postoperative morbidity associated with esophagectomy and to test their performance using a population-based large database. Methods: A total of 10 862 patients who underwent esophagectomy between January 2011 and December 2012 derived from the Japanese national clinical database (NCD) were included. Based on the 148 preoperative clinical variables collected, risk prediction models for eight major postoperative morbidities were created using 80% (8715 patients) of the study population and validated using the remaining 20% (2147 patients) of the patients. Results: The mortality rate was 3.1% and postoperative morbidity was observed in 42.6% of the patients. The c-statistics of the eight risk models established by the training set were surgical site infection (0.564), anastomotic leakage (0.531), need for transfusion (0.636), blood loss >1000 mL (0.644), pneumonia (0.632), unplanned intubation (0.607), prolonged mechanical ventilation over 48 hours (0.614), and sepsis (0.618) in the validation analysis. Conclusions: Risk prediction models for postoperative morbidity after esophagectomy using the population-based large database showed relatively fair performance. The current models may offer baseline information for risk stratification in clinical decision makings and help select more suitable surgical and nonsurgical treatment options and future clinical studies.

Original languageEnglish
JournalJournal of Surgical Oncology
DOIs
Publication statusAccepted/In press - 2019 Jan 1
Externally publishedYes

Fingerprint

Esophagectomy
Japan
Databases
Morbidity
Population
Surgical Wound Infection
Anastomotic Leak
Artificial Respiration
Intubation
Blood Transfusion
Sepsis
Pneumonia
Mortality
Incidence

Keywords

  • esophagectomy
  • major complications
  • risk model

ASJC Scopus subject areas

  • Surgery
  • Oncology

Cite this

Development of a model predicting the risk of eight major postoperative complications after esophagectomy based on 10 826 cases in the Japan National Clinical Database. / Ohkura, Yu; Miyata, Hiroaki; Konno, Hiroyuki; Udagawa, Harushi; Ueno, Masaki; Shindoh, Junichi; Kumamaru, Hiraku; Wakabayashi, Go; Gotoh, Mitsukazu; Mori, Masaki.

In: Journal of Surgical Oncology, 01.01.2019.

Research output: Contribution to journalArticle

Ohkura, Yu ; Miyata, Hiroaki ; Konno, Hiroyuki ; Udagawa, Harushi ; Ueno, Masaki ; Shindoh, Junichi ; Kumamaru, Hiraku ; Wakabayashi, Go ; Gotoh, Mitsukazu ; Mori, Masaki. / Development of a model predicting the risk of eight major postoperative complications after esophagectomy based on 10 826 cases in the Japan National Clinical Database. In: Journal of Surgical Oncology. 2019.
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abstract = "Background: Esophagectomy is a highly invasive procedure with a high incidence of complications. The objectives of this study were to create risk prediction models for postoperative morbidity associated with esophagectomy and to test their performance using a population-based large database. Methods: A total of 10 862 patients who underwent esophagectomy between January 2011 and December 2012 derived from the Japanese national clinical database (NCD) were included. Based on the 148 preoperative clinical variables collected, risk prediction models for eight major postoperative morbidities were created using 80{\%} (8715 patients) of the study population and validated using the remaining 20{\%} (2147 patients) of the patients. Results: The mortality rate was 3.1{\%} and postoperative morbidity was observed in 42.6{\%} of the patients. The c-statistics of the eight risk models established by the training set were surgical site infection (0.564), anastomotic leakage (0.531), need for transfusion (0.636), blood loss >1000 mL (0.644), pneumonia (0.632), unplanned intubation (0.607), prolonged mechanical ventilation over 48 hours (0.614), and sepsis (0.618) in the validation analysis. Conclusions: Risk prediction models for postoperative morbidity after esophagectomy using the population-based large database showed relatively fair performance. The current models may offer baseline information for risk stratification in clinical decision makings and help select more suitable surgical and nonsurgical treatment options and future clinical studies.",
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AU - Ueno, Masaki

AU - Shindoh, Junichi

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