Comparisons of postoperative outcomes after breast cancer surgery in patients with and without renal replacement therapy: a matched-pair cohort study using a Japanese nationwide inpatient database

Konishi, Takaaki; Fujiogi, Michimasa; Michihata, Nobuaki; Morita, Kojiro; Matsui, Hiroki; Fushimi, Kiyohide; Tanabe, Masahiko; Seto, Yasuyuki; Yasunaga, Hideo

doi:10.1007/s12282-021-01248-7

Cited by 3 publications

(2 citation statements)

References 36 publications

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“…We chose Charlson and Elixhauser comorbidities as candidate comorbidities and their ICD‐10 codes were defined with reference to a previous study (details and corresponding ICD‐10 codes are shown in Supplementary Table 1 ) [16]. Similar to previous studies, we excluded breast cancer and axillary metastasis from the definition of comorbidities because they were the main disease [17, 18]. We defined heparin use as intravenous continuous administration and steroid use as oral and intravenous administration.…”

Section: Methodsmentioning

confidence: 99%

Risk Factors for Postoperative Bleeding Following Breast Cancer Surgery: A Nationwide Database Study of 477,108 Cases in Japan

et al. 2022

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Background Although postoperative bleeding is a common and serious complication in breast cancer surgery, the risk factors remain unclear. Therefore, we examined the risk factors using a Japanese nationwide database. Methods Patients who underwent breast cancer surgery between July 2010 and March 2020 were identified from a Japanese nationwide database. Multivariable analyses for 47 candidate risk factors (4 patient characteristics, 32 comorbidities, 5 tumor characteristics, 3 preoperative drug uses, and 3 surgical procedures) were conducted to investigate risk factors associated with postoperative bleeding requiring reoperation. Two sensitivity analyses were conducted: an analysis for postoperative bleeding with or without reoperation and an analysis for patients who underwent total mastectomy without breast reconstruction. Results Among the 477,108 patients included, 7048 (1.5%) developed postoperative bleeding and 2357 (0.5%) underwent reoperation for postoperative bleeding. Male sex, old age, body mass index ≥ 25.0 kg/m2, several comorbidities (deficiency anemia, cardiac arrhythmias, hypertension, liver disease, psychoses, and valvular disease), preoperative heparin use, and several procedures were identified as risk factors. Deficiency anemia showed the highest odds ratio among the risk factors (4.41 [95% confidence interval, 3.63–5.36]). High odds ratios were also observed in total mastectomy (2.32 [2.10–2.56]), flap reconstruction (1.93 [1.55–2.40]), and preoperative heparin use (1.64 [1.26–2.14]). The results corresponded with the sensitivity analyses. Conclusions This study identified several risk factors for postoperative bleeding in breast cancer surgery, such as high body mass index, anemia, cardiovascular diseases, liver diseases, psychoses, preoperative heparin use, and surgical procedures.

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Section: Methodsmentioning

confidence: 99%

Risk Factors for Postoperative Bleeding Following Breast Cancer Surgery: A Nationwide Database Study of 477,108 Cases in Japan

et al. 2022

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“…Since mastectomy is seldom associated with severe postoperative complications, it requires shorter LOS than other oncological surgeries (15) ; the mean LOS reported in previous Western nationwide studies is 1-2 days (15) , (16) . However, since LOS in Japan is generally much longer (approximately three times) than that in other countries (17) , the mean LOS for breast cancer surgery in Japan is approximately 1 week, despite few complications (18) , (19) .…”

Section: Introductionmentioning

confidence: 99%

Association of Operative Day of the Week with the Length of Stay and Total Hospitalization Costs in Patients with Partial Mastectomy: A Nationwide Database Study in Japan

Konishi

Fujiogi

Michihata

et al. 2022

JMA J

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Introduction: Length of stay (LOS) is a major concern while optimizing medical resources and costs. Hence, factors influencing LOS should be investigated. In Japan, breast cancer surgery generally involves several days of hospitalization for observation, despite few complications. We hypothesized that the day of surgery (weekday; Monday-Friday) affects LOS. Methods: Using a Japanese nationwide database, we retrospectively identified 146,610 patients who underwent partial mastectomy for stage 0-III breast cancer from July 2010 to March 2017. We conducted multivariable linear and logistic regression analyses adjusting for background characteristics (such as comorbidities and hospital characteristics) with a generalized estimating equation for within-hospital clustering to compare postoperative and total LOS, total hospitalization costs, and postoperative complications between the groups for whom the surgery was performed on different days of the week. Results: In total, whereas the median postoperative LOS was 4 days (interquartile range, 3-6 days), the median total LOS was 6 days (5-8 days). The median total hospitalization cost was 6,189 US dollars (5,609-6,668 US dollars), and postoperative complications occurred in 3.3% of cases. Despite no significant difference in postoperative complications, Monday-Wednesday surgeries showed significantly shorter postoperative LOS than Friday surgeries (−0.11 days [95% confidence interval, −0.14 to −0.07] on Monday with reference to Friday). Nevertheless, Monday surgeries showed significantly increased total LOS (0.69 days [0.64-0.74]) and hospitalization costs (93 US dollars [71-116]) in comparison with Friday surgeries. Conclusions: The operative day of the week was associated with increased LOS and cost, with no difference in postoperative complications after partial mastectomy. Surgeries on Monday involved longer preoperative hospital stays and higher total hospitalization costs than those on other weekdays.

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Short-Term Outcomes Following Breast Cancer Surgery With and Without Neoadjuvant Chemotherapy: A Nationwide Administrative Database Study in Japan

et al. 2022

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Comparisons of postoperative outcomes after breast cancer surgery in patients with and without renal replacement therapy: a matched-pair cohort study using a Japanese nationwide inpatient database

Cited by 3 publications

References 36 publications

Risk Factors for Postoperative Bleeding Following Breast Cancer Surgery: A Nationwide Database Study of 477,108 Cases in Japan

Risk Factors for Postoperative Bleeding Following Breast Cancer Surgery: A Nationwide Database Study of 477,108 Cases in Japan

Association of Operative Day of the Week with the Length of Stay and Total Hospitalization Costs in Patients with Partial Mastectomy: A Nationwide Database Study in Japan

Short-Term Outcomes Following Breast Cancer Surgery With and Without Neoadjuvant Chemotherapy: A Nationwide Administrative Database Study in Japan

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