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Surgery Today
Published in: Surgery Today 10/2015

01-10-2015 | Original Article

Surgical risk model for acute diffuse peritonitis based on a Japanese nationwide database: an initial report on the surgical and 30-day mortality

Authors: Tohru Nakagoe, Hiroaki Miyata, Mitsukazu Gotoh, Takayuki Anazawa, Hideo Baba, Wataru Kimura, Naohiro Tomita, Mitsuo Shimada, Yuko Kitagawa, Kenichi Sugihara, Masaki Mori

Published in: Surgery Today | Issue 10/2015

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Abstract

Purpose

Acute diffuse peritonitis (ADP) is an important surgical complication associated with high morbidity and mortality; however, the risk factors associated with a poor outcome have remained controversial. This study aimed in collecting integrated data using a web-based national database system to build a risk model for mortality after surgery for ADP.

Methods

We included cases registered in the National Clinical Database in Japan. After data cleanup, 8,482 surgical cases of ADP from 1,285 hospitals treated between January 1 and December 31, 2011 were analyzed.

Results

The raw 30-day and surgical mortality rates were 9.0 and 14.1 %, respectively. The odds ratios (>2.0) for 30-day mortality were as follows: American Society of Anesthesiologists (ASA) class 3, 2.69; ASA class 4, 4.28; ASA class 5, 8.65; previous percutaneous coronary intervention (PCI), 2.05; previous surgery for peripheral vascular disease (PVD), 2.45 and disseminated cancer, 2.16. The odds ratios (>2.0) for surgical mortality were as follows: ASA class 3, 2.27; ASA class 4, 4.67; ASA class 5, 6.54, and disseminated cancer, 2.09. The C-indices of 30-day and surgical mortality were 0.851 and 0.852, respectively.

Conclusion

This is the first report of risk stratification after surgery for ADP using a nationwide surgical database. This system could be useful to predict the outcome of surgery for ADP and for evaluations and benchmark performance studies.
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Metadata
Title
Surgical risk model for acute diffuse peritonitis based on a Japanese nationwide database: an initial report on the surgical and 30-day mortality
Authors
Tohru Nakagoe
Hiroaki Miyata
Mitsukazu Gotoh
Takayuki Anazawa
Hideo Baba
Wataru Kimura
Naohiro Tomita
Mitsuo Shimada
Yuko Kitagawa
Kenichi Sugihara
Masaki Mori
Publication date
01-10-2015
Publisher
Springer Japan
Published in
Surgery Today / Issue 10/2015
Print ISSN: 0941-1291
Electronic ISSN: 1436-2813
DOI
https://doi.org/10.1007/s00595-014-1026-x

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