ArticleGastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association2017
Modeling preoperative risk factors for potentially lethal morbidities using a nationwide Japanese web-based database of patients undergoing distal gastrectomy for gastric cancer.
Article in Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 47 papers, 2 of them syntheses that pooled it.
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Who cites it
47 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Prediction models for postoperative pulmonary complications: a systematic review and meta-analysis.British journal of anaesthesia · 2025Pooled it
- Prediction models for patients with esophageal or gastric cancer: A systematic review and meta-analysis.PloS one · 2018Pooled it
- Annual Report of the 2022 National Clinical Database: Decade-Long Trends and Current Status of Gastroenterological Surgery in Japan.Annals of gastroenterological surgery · 2026Article
- Which Method Best Predicts Postoperative Complications: Deep Learning, Machine Learning, or Conventional Logistic Regression?Annals of gastroenterological surgery · 2026Review
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- Deep Learning Model for Predicting Operative Mortality After Total Gastrectomy: Analysis of the Japanese National Clinical Database (NCD).Annals of gastroenterological surgery · 2026Article
- Time-sequential prediction of postoperative complications after gastric cancer surgery using machine learning: a multicenter cohort study.Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association · 2025Article
- Effect on short-term outcomes of the COVID-19 pandemic following laparoscopic distal gastrectomy and low anterior resection for gastric and rectal cancer: A retrospective study using the Japanese National Clinical Database, 2018-2022.Annals of gastroenterological surgery · 2025Article
- Risk factors for serious postoperative complications following gastrectomy in super-elderly patients ≥85-years-old with gastric cancer: A National Clinical Database study in Japan.Annals of gastroenterological surgery · 2025Article
- Annual report on National Clinical Database 2021 for gastroenterological surgery in Japan.Annals of gastroenterological surgery · 2025Article
- Clinical Impact of Sarcopenia in the Decision-Making Process for Patients with Acute Diverticulitis.Journal of clinical medicine · 2024Article
- Impact of infectious complications after gastrectomy on non‑gastric cancer‑related deaths.Oncology letters · 2024Article
- 1657 Resected Gastric Adenocarcinomas at a Single Institution: Outcomes and Trends over 17 Years.Annals of surgical oncology · 2024Article
- Impact of SARS-CoV-2 infection on short-term postoperative outcomes after gastroenterological cancer surgery using data from a nationwide database in Japan.Annals of gastroenterological surgery · 2024Article
- Risk factors for infectious complications after gastrectomy in older patients.Experimental and therapeutic medicine · 2024Article
- Article
- Investigation of the impact of COVID-19 on postoperative outcomes using a nationwide Japanese database of patients undergoing laparoscopic distal gastrectomy and low anterior resection for gastric cancer and rectal cancer.Annals of gastroenterological surgery · 2024Article
- Risk factors for death from other diseases after curative gastrectomy and lymph node dissection for gastric cancer.BMC surgery · 2024Article
- Skill-qualified surgeons positively affect short-term outcomes after laparoscopic gastrectomy for gastric cancer: a survey of the National Clinical Database of Japan.Surgical endoscopy · 2023Article
- Annual report on National Clinical Database 2020 for gastroenterological surgery in Japan.Annals of gastroenterological surgery · 2023Article
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9 authors.
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Abstract
backgroundMost risk models for mortality and morbidity after distal gastrectomy have been created based on relatively small retrospective studies, and a model originating from nationwide database has been lacking. This study aimed to identify preoperative risk factors that predict the postoperative morbidities closely associated with mortality in gastric cancer patients undergoing distal gastrectomy, using data from the National Clinical Database (NCD), a nationwide web-based database in Japan.
methodsWe analyzed records from the NCD for 65,906 patients who underwent distal gastrectomy in 1,986 hospitals during 2011 and 2012. Using 80 % of these patients, we identified independent preoperative predictors for morbidities closely related with mortality. These risk factors were then validated using the remaining 20 % of patients from 2011 to 2012 and the further 35,575 records from 2013.
resultsOperative mortality was 1.07 % and overall morbidity was 14.2 % for the development data set. We selected eight morbidities that were closely associated with postoperative mortality, and then identified between 13 and 25 independent preoperative risk factors for each of the eight morbidities. Of these, old age, female gender, and poor ADL were the factors most frequently associated with the morbidities. The C-indices for each morbidity from the 2011 to 2012 validation data set were favorable as follows: unplanned intubation (0.797), pneumonia (0.784), systemic sepsis (0.748), renal failure (0.832), cardiac events (0.728), large blood transfusions (0.700), central nervous system (CNS) events (0.779), and anastomotic leakage (0.658). Similar C-indices were obtained for each mortality using the 2013 validation data set.
conclusionsIn this study, we successfully constructed an acceptable risk model using preoperative risk factors to predict eight postoperative morbidities highly associated with mortality in gastric cancer patients. This risk model could help to tailor perioperative management and improve clinical outcomes for patients who undergo distal gastrectomy.
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