caa a22 4500 445333235 CHVBK 20180317142744.0 cr unu---uuuuu 170323e20110601xx s 000 0 eng 10.1245/s10434-010-1502-5 doi (NATIONALLICENCE)springer-10.1245/s10434-010-1502-5 In-Hospital Mortality After a Surgical Resection for Esophageal Cancer: Analyses of the Associated Factors and Historical Changes [Elektronische Daten] [Masaru Morita, Tomonori Nakanoko, Yoshihiko Fujinaka, Nobuhide Kubo, Natsumi Yamashita, Keiji Yoshinaga, Hiroshi Saeki, Yasunori Emi, Yoshihiro Kakeji, Ken Shirabe, Yoshihiko Maehara] Background: Resections for esophageal cancer are invasive, with high mortality and morbidity rates. The object of this study was to clarify the factors associated with in-hospital death while also evaluating any associated historical changes in the characteristics of such deaths. Methods: The factors associated with mortality were examined by logistic regression analysis in 1106 patients who underwent an esophagectomy for esophageal cancer. The historical changes in the characteristics of in-hospital deaths were also evaluated. Results: A multivariate analysis revealed that not only undergoing an esophagectomy before 1979, but also a patient's age (odds ratio 1.070 for every increase in age by year) and an incomplete resection (odds ratio 2.265) were independent factors associated with in-hospital death. The in-hospital mortality rates were 16.1%, 5.8%, 2.5%, and 3.1%, while the 30-day mortality rates were 9.2%, 2.2%, 0.8%, and 0.3% during 1964-1979, the 1980s, the 1990s, and the 2000s, respectively. Eight patients had preoperative comorbidities among 11 patients who died in the hospital after 1997. The mortality rate was 5.5% in patients with any comorbidities, while it was 1.3% in patients without any comorbidities (P=0.026). The most common direct cause of in-hospital death was previous pulmonary complications; however, cancer progression has recently become the most common cause. Conclusions: To prevent in-hospital mortality after an esophagectomy, strict indications for surgery and careful perioperative management are important, especially in high-risk patients with advanced esophageal cancer. Society of Surgical Oncology, 2010 Morita Masaru Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan aut Nakanoko Tomonori Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan aut Fujinaka Yoshihiko Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan aut Kubo Nobuhide Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan aut Yamashita Natsumi Department of Innovative Applied Oncology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan aut Yoshinaga Keiji Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan aut Saeki Hiroshi Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan aut Emi Yasunori Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan aut Kakeji Yoshihiro Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan aut Shirabe Ken Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan aut Maehara Yoshihiko Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan aut Annals of Surgical Oncology Springer-Verlag 18/6(2011-06-01), 1757-1765 1068-9265 18:6<1757 2011 18 10434 https://doi.org/10.1245/s10434-010-1502-5 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1245/s10434-010-1502-5 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Morita Masaru Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan aut NATIONALLICENCE 700 1- Nakanoko Tomonori Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan aut NATIONALLICENCE 700 1- Fujinaka Yoshihiko Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan aut NATIONALLICENCE 700 1- Kubo Nobuhide Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan aut NATIONALLICENCE 700 1- Yamashita Natsumi Department of Innovative Applied Oncology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan aut NATIONALLICENCE 700 1- Yoshinaga Keiji Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan aut NATIONALLICENCE 700 1- Saeki Hiroshi Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan aut NATIONALLICENCE 700 1- Emi Yasunori Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan aut NATIONALLICENCE 700 1- Kakeji Yoshihiro Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan aut NATIONALLICENCE 700 1- Shirabe Ken Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan aut NATIONALLICENCE 700 1- Maehara Yoshihiko Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan aut NATIONALLICENCE 773 0- Annals of Surgical Oncology Springer-Verlag 18/6(2011-06-01), 1757-1765 1068-9265 18:6<1757 2011 18 10434 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer