オガワ　シンペイ   OGAWA Shinpei   小川　真平    所属   医学部 医学科（東京女子医科大学病院）    職種   准教授
論文種別	原著
言語種別	英語
査読の有無	査読なし
表題	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
掲載誌名	正式名：Annals of gastroenterological surgery 略　 称：Ann Gastroenterol Surg ISSNコード：24750328/24750328
掲載区分	国内
巻・号・頁	8(3),pp.450-463
著者・共著者	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
担当区分	筆頭著者
発行年月	2024/05
概要	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.
DOI	10.1002/ags3.12758
PMID	38707225