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Effects of the COVID-19 pandemic on short-term postoperative outcomes for colorectal perforation: A nationwide study in Japan based on the National Clinical Database.
Ogawa, Shimpei; Endo, Hideki; Yoshida, Masahiro; Tsuru, Tomomitsu; Itabashi, Michio; Yamamoto, Hiroyuki; Kakeji, Yoshihiro; Ueno, Hideki; Kitagawa, Yuko; Hibi, Taizo; Taketomi, Akinobu; Ikeda, Norihiko; Mori, Masaki.
Afiliación
  • Ogawa S; The Japanese Society for Abdominal Emergency Medicine Tokyo Japan.
  • Endo H; Department of Surgery, Institute of Gastroenterology Tokyo Women's Medical University Tokyo Japan.
  • Yoshida M; Department of Healthcare Quality Assessment, Graduate School of Medicine The University of Tokyo Tokyo Japan.
  • Tsuru T; The Japanese Society for Abdominal Emergency Medicine Tokyo Japan.
  • Itabashi M; Department of HBP and Gastrointestinal Surgery International University of Health and Welfare Ichikawa Japan.
  • Yamamoto H; The Japanese Society for Abdominal Emergency Medicine Tokyo Japan.
  • Kakeji Y; Department of Medical Education and Training, Shin-Koga Hospital Kurume, Fukuoka Japan.
  • Ueno H; The Japanese Society for Abdominal Emergency Medicine Tokyo Japan.
  • Kitagawa Y; Department of Surgery, Institute of Gastroenterology Tokyo Women's Medical University Tokyo Japan.
  • Hibi T; Department of Healthcare Quality Assessment, Graduate School of Medicine The University of Tokyo Tokyo Japan.
  • Taketomi A; Database Committee, The Japanese Society of Gastroenterological Surgery Tokyo Japan.
  • Ikeda N; Division of Gastrointestinal Surgery, Department of Surgery Kobe University Graduate School of Medicine Kobe Hyogo Japan.
  • Mori M; Database Committee, The Japanese Society of Gastroenterological Surgery Tokyo Japan.
Ann Gastroenterol Surg ; 8(3): 450-463, 2024 May.
Article en En | MEDLINE | ID: mdl-38707225
ABSTRACT

Aim:

Possible negative effects of the COVID-19 pandemic on short-term postoperative outcomes for colorectal perforation in Japan were examined in this study.

Methods:

The National Clinical Database (NCD) is a large-scale database including more than 95% of surgical cases in Japan. We analyzed 13 107 cases of colorectal perforation from 2019 to 2021. National data were analyzed, and subgroup analyses were conducted for subjects in prefectures with high infection levels (HILs) and metropolitan areas (Tokyo Met. and Osaka Pref.). Postoperative 30-day mortality, surgical mortality, and postoperative complications (Clavien-Dindo grade ≥3) were examined. Months were considered to have significantly high or low mortality or complication rates, if the 95% confidence interval (CI) of the standardized mortality (morbidity) ratio (SMR) does not contain 1.

Results:

In the NCD, postoperative 30-day mortality occurred in 1371 subjects (10.5%), surgical mortality in 1805 (13.8%), and postoperative complications in 3950 (30.1%). Significantly higher SMRs were found for 30-day mortality in November 2020 (14.6%, 1.39 [95% CI 1.04-1.83]) and February 2021 (14.6%, 1.48 [95% CI 1.10-1.96]), and for postoperative complications in June 2020 (37.3%, 1.28 [95% CI 1.08-1.52]) and November 2020 (36.4%, 1.21 [95% CI 1.01-1.44]). The SMRs for surgical mortality were not significantly high in any month. In prefectures with HILs and large metropolitan areas, there were few months with significantly higher SMRs.

Conclusions:

The COVID-19 pandemic had limited negative effects on postoperative outcomes in patients with colorectal perforation. These findings suggest that the emergency system for colorectal perforation in Japan was generally maintained during the pandemic.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Ann Gastroenterol Surg Año: 2024 Tipo del documento: Article Pais de publicación: Japón
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Ann Gastroenterol Surg Año: 2024 Tipo del documento: Article Pais de publicación: Japón