Risk model for mortality associated with esophagectomy via a thoracic approach based on data from the Japanese National Clinical Database on malignant esophageal tumors

Akira Sasaki, Hisateru Tachimori, Yuji Akiyama, Taro Oshikiri, Hiroaki Miyata, Yoshihiro Kakeji, Yuko Kitagawa

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: Postoperative complications after esophagectomy can be severe or fatal and impact the patient’s postoperative quality of life and long-term outcomes. The aim of the present study was to develop the best possible model for predicting mortality and complications based on the Japanese Nationwide Clinical Database (NCD). Methods: Data registered in the NCD, on 32,779 patients who underwent esophagectomy via a thoracic approach for malignant esophageal tumor between January, 2012 and December, 2017, were used to create a risk model. Results: The 30-day mortality rate after esophagectomy was 1.0%, and the operative mortality rate was 2.3%. Postoperative complications included pneumonia (13.8%), anastomotic leakage (13.2%), recurrent laryngeal nerve palsy (11.1%), atelectasis (4.9%), and chylothorax (2.5%). Postoperative artificial respiration for over 48 h was required by 7.8% of the patients. Unplanned intubation within 30 postoperative days was performed in 6.2% of the patients. C-indices evaluated using the test data were 0.694 for 30-day mortality and 0.712 for operative mortality. Conclusions: We developed a good risk model for predicting 30-day mortality and operative mortality after esophagectomy based on the NCD. This risk model will be useful for the preoperative prediction of 30-day mortality and operative mortality, obtaining informed consent, and deciding on the optimal surgical procedure for patients with preoperative risks for mortality.

Original languageEnglish
JournalSurgery today
DOIs
Publication statusAccepted/In press - 2022

Keywords

  • 30-Day mortality
  • Esophageal cancer
  • Esophagectomy
  • Operative mortality
  • Risk model

ASJC Scopus subject areas

  • Surgery

Fingerprint

Dive into the research topics of 'Risk model for mortality associated with esophagectomy via a thoracic approach based on data from the Japanese National Clinical Database on malignant esophageal tumors'. Together they form a unique fingerprint.

Cite this