Association of day of the week with mortality after elective right hemicolectomy for colon cancer: Case analysis from the National Clinical Database
Abstract Aim We aimed to investigate whether later weekdays are related to worse short‐term outcomes after elective right hemicolectomy for colon cancer. Methods We retrospectively analyzed adult patients who underwent elective right hemicolectomy for colon cancer between 2012 and 2017. Records lack...
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doaj-25b54084c6ce41aa832aa12636aca0c62021-05-29T17:24:34ZengWileyAnnals of Gastroenterological Surgery2475-03282021-05-015333133710.1002/ags3.12420Association of day of the week with mortality after elective right hemicolectomy for colon cancer: Case analysis from the National Clinical DatabaseHiromichi Maeda0Hideki Endo1Nao Ichihara2Hiroaki Miyata3Hiroshi Hasegawa4Kinji Kamiya5Yoshihiro Kakeji6Kazuhiro Yoshida7Yasuyuki Seto8Hiroki Yamaue9Masakazu Yamamoto10Yuko Kitagawa11Sunao Uemura12Kazuhiro Hanazaki13Department of Surgery Kochi Medical School Nankoku JapanDepartment of Healthcare Quality Assessment Graduate School of Medicine The University of Tokyo Bunkyo‐ku JapanDepartment of Healthcare Quality Assessment Graduate School of Medicine The University of Tokyo Bunkyo‐ku JapanDepartment of Healthcare Quality Assessment Graduate School of Medicine The University of Tokyo Bunkyo‐ku JapanProject Management Subcommittee The Japanese Society of Gastroenterological Surgery Tokyo JapanProject Management Subcommittee The Japanese Society of Gastroenterological Surgery Tokyo JapanDatabase Committee The Japanese Society of Gastroenterological Surgery Tokyo JapanDepartment of Surgical Oncology Graduate School of Medicine Gifu University Gifu JapanDepartment of Gastrointestinal Surgery Graduate School of Medicine The University of Tokyo Bunkyo‐ku JapanSecond Department of Surgery School of Medicine Wakayama Medical University Wakayama JapanDepartment of Surgery Institute of Gastroenterology Tokyo Women's Medical University Shinjuku‐ku JapanThe Japanese Society of Gastroenterological Surgery Tokyo JapanDepartment of Surgery Kochi Medical School Nankoku JapanDepartment of Surgery Kochi Medical School Nankoku JapanAbstract Aim We aimed to investigate whether later weekdays are related to worse short‐term outcomes after elective right hemicolectomy for colon cancer. Methods We retrospectively analyzed adult patients who underwent elective right hemicolectomy for colon cancer between 2012 and 2017. Records lacking details about surgical mortality were excluded, and multiple imputation was performed for other missing data (variables). The primary endpoint was surgical mortality, defined as the sum of 30‐day mortality and in‐hospital deaths within 90 days postoperatively. Using 22 clinical variables, hierarchal logistic regression modeling with clustering of patients from the same institutes was performed. Results Of the 112 658 patients undergoing elective right hemicolectomy for colon cancer, the 30‐day mortality and surgical mortality were 0.6% and 1.1%, respectively. Surgery on Friday was less frequent, accounting for 17.1% of all cases. The occurrence of severe postoperative complications, anastomotic leakage, or unadjusted odds ratio for surgical mortality did not show significant differences between weekdays. A hierarchal logistic regression model identified 19 independent factors for surgical mortality. Adjusted odds ratios for surgical mortality were 1.01 (95% confidence interval: 0.83‐1.22, P = .915), 0.86 (95% confidence interval: 0.71‐1.05, P = .144), 0.86 (95% confidence interval: 0.71‐1.05, P = .408), and 0.83 (95% confidence interval: 0.68‐1.03, P = .176) for Tuesday, Wednesday, Thursday, and Friday, respectively, showing no significant differences. Conclusion This study did not identify an evident difference in surgical mortality between weekdays; a safe elective right hemicolectomy for colon cancer is being offered throughout the week in Japan.https://doi.org/10.1002/ags3.12420colectomycolonic neoplasmselective surgical procedureshospital mortalitytreatment outcome |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Hiromichi Maeda Hideki Endo Nao Ichihara Hiroaki Miyata Hiroshi Hasegawa Kinji Kamiya Yoshihiro Kakeji Kazuhiro Yoshida Yasuyuki Seto Hiroki Yamaue Masakazu Yamamoto Yuko Kitagawa Sunao Uemura Kazuhiro Hanazaki |
spellingShingle |
Hiromichi Maeda Hideki Endo Nao Ichihara Hiroaki Miyata Hiroshi Hasegawa Kinji Kamiya Yoshihiro Kakeji Kazuhiro Yoshida Yasuyuki Seto Hiroki Yamaue Masakazu Yamamoto Yuko Kitagawa Sunao Uemura Kazuhiro Hanazaki Association of day of the week with mortality after elective right hemicolectomy for colon cancer: Case analysis from the National Clinical Database Annals of Gastroenterological Surgery colectomy colonic neoplasms elective surgical procedures hospital mortality treatment outcome |
author_facet |
Hiromichi Maeda Hideki Endo Nao Ichihara Hiroaki Miyata Hiroshi Hasegawa Kinji Kamiya Yoshihiro Kakeji Kazuhiro Yoshida Yasuyuki Seto Hiroki Yamaue Masakazu Yamamoto Yuko Kitagawa Sunao Uemura Kazuhiro Hanazaki |
author_sort |
Hiromichi Maeda |
title |
Association of day of the week with mortality after elective right hemicolectomy for colon cancer: Case analysis from the National Clinical Database |
title_short |
Association of day of the week with mortality after elective right hemicolectomy for colon cancer: Case analysis from the National Clinical Database |
title_full |
Association of day of the week with mortality after elective right hemicolectomy for colon cancer: Case analysis from the National Clinical Database |
title_fullStr |
Association of day of the week with mortality after elective right hemicolectomy for colon cancer: Case analysis from the National Clinical Database |
title_full_unstemmed |
Association of day of the week with mortality after elective right hemicolectomy for colon cancer: Case analysis from the National Clinical Database |
title_sort |
association of day of the week with mortality after elective right hemicolectomy for colon cancer: case analysis from the national clinical database |
publisher |
Wiley |
series |
Annals of Gastroenterological Surgery |
issn |
2475-0328 |
publishDate |
2021-05-01 |
description |
Abstract Aim We aimed to investigate whether later weekdays are related to worse short‐term outcomes after elective right hemicolectomy for colon cancer. Methods We retrospectively analyzed adult patients who underwent elective right hemicolectomy for colon cancer between 2012 and 2017. Records lacking details about surgical mortality were excluded, and multiple imputation was performed for other missing data (variables). The primary endpoint was surgical mortality, defined as the sum of 30‐day mortality and in‐hospital deaths within 90 days postoperatively. Using 22 clinical variables, hierarchal logistic regression modeling with clustering of patients from the same institutes was performed. Results Of the 112 658 patients undergoing elective right hemicolectomy for colon cancer, the 30‐day mortality and surgical mortality were 0.6% and 1.1%, respectively. Surgery on Friday was less frequent, accounting for 17.1% of all cases. The occurrence of severe postoperative complications, anastomotic leakage, or unadjusted odds ratio for surgical mortality did not show significant differences between weekdays. A hierarchal logistic regression model identified 19 independent factors for surgical mortality. Adjusted odds ratios for surgical mortality were 1.01 (95% confidence interval: 0.83‐1.22, P = .915), 0.86 (95% confidence interval: 0.71‐1.05, P = .144), 0.86 (95% confidence interval: 0.71‐1.05, P = .408), and 0.83 (95% confidence interval: 0.68‐1.03, P = .176) for Tuesday, Wednesday, Thursday, and Friday, respectively, showing no significant differences. Conclusion This study did not identify an evident difference in surgical mortality between weekdays; a safe elective right hemicolectomy for colon cancer is being offered throughout the week in Japan. |
topic |
colectomy colonic neoplasms elective surgical procedures hospital mortality treatment outcome |
url |
https://doi.org/10.1002/ags3.12420 |
work_keys_str_mv |
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