Evidence map›Paper›PMID 28079809›Full record

Observational studyMedicine2017

A comparison of the surgical mortality due to colorectal perforation at different hospitals with data from 10,090 cases in the Japanese National Clinical Database.

Takeshi Ohki, Masakazu Yamamoto, Hiroaki Miyata, Yasuto Sato, Yoshihisa Saida, Tsuyoshi Morimoto, Hiroyuki Konno, Yasuyuki Seto, Koichi Hirata

Erratum issuedAbstract readComparative StudyObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Medicine, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Article
  2. Article
  3. Review
  4. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

9 authors.

Takeshi OhkiaDepartment of Surgery, Institute of Gastroenterology, Tokyo Women's Medical University bNational Clinical Database cDepartment of Health Policy and Management, School of Medicine, Keio University dDepartment of Public Health, Tokyo Women's Medical University eDepartment of Surgery, Toho University Ohashi Medical Centre, Tokyo fDepartment of Radiology, St. Marianna University School of Medicine, Kawasaki gThe Japanese Society of Gastroenterological Surgery, Tokyo hSecond Department of Surgery, Hamamatsu University School of Medicine, Hamamatsu iDepartment of Gastrointestinal Surgery, Graduate School of Medicine and Faculty of Medicine, The University of Tokyo jThe Japanese Society for Abdominal Emergency Medicine, Tokyo kFirst department of surgery of Sapporo Medical university school of Medicine, Sapporo lDepartment of Surgery, JR Sapporo Hospital, Sapporo, Japan.
Masakazu Yamamoto
Hiroaki Miyata
Yasuto Sato
Yoshihisa Saida
Tsuyoshi Morimoto
Hiroyuki Konno
Yasuyuki Seto
Koichi Hirata

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Colorectal perforation has a high rate of mortality. We compared the incidence and fatality rates of colorectal perforation among different hospitals in Japan using data from the nationwide surgical database.Patients were registered in the National Clinical Database (NCD) between January 1st, 2011 and December 31st, 2013. Patients with colorectal perforation were identified from surgery records by examining if acute diffuse peritonitis (ADP) and diseases associated with a high probability of colorectal perforation were noted. The primary outcome measures included the 30-day postsurgery mortality and surgical mortality of colorectal perforation. We analyzed differences in the observed-to-expected mortality (O/E) ratio between the two groups of hospitals, that is, specialized and non-specialized, using the logistic regression analysis forward selection method.There were 10,090 cases of disease-induced colorectal perforation during the study period. The annual average postoperative fatality rate was 11.36%. There were 3884 patients in the specialized hospital group and 6206 in the non-specialized hospital group. The O/E ratio (0.9106) was significantly lower in the specialized hospital group than in the non-specialized hospital group (1.0704). The experience level of hospitals in treating cases of colorectal perforation negatively correlated with the O/E ratio.We conducted the first study investigating differences among hospitals with respect to their fatality rate of colorectal perforation on the basis of data from a nationwide database. Our data suggest that patients with colorectal perforation should choose to be treated at a specialized hospital or a hospital that treats five or more cases of colorectal perforation per year. The results of this study indicate that specialized hospitals may provide higher quality medical care, which in turn proves that government policy on healthcare is effective at improving the medical system in Japan.

Indexed as

Hospital MortalityAppendectomyColonic DiseasesColostomyHospitalsHospitals, SpecialHumansIncidenceIntestinal PerforationJapanPostoperative ComplicationsQuality of Health CareRectal Diseases

Identifiers

PMID28079809
PMCPMC5266171

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.