- 著者
- Michimasa Fujiogi Nobuaki Michihata Hiroki Matsui Kiyohide Fushimi Hideo Yasunaga Jun Fujishiro
- 出版者
- Society for Clinical Epidemiology
- 雑誌
- Annals of Clinical Epidemiology (ISSN:24344338)
- 巻号頁・発行日
- vol.2, no.2, pp.61-68, 2020 (Released:2020-04-28)
- 参考文献数
- 23
BACKGROUNDOmphalocele is frequently detected prenatally worldwide. Nevertheless, little is known about patient demographics, practice pattern and outcomes.METHODSWe examined patient demographics, treatment options, and outcomes for patients with omphalocele with and without severe chromosomal abnormalities (trisomy 13 and 18), July 2010–March 2016, using a nationwide database in Japan.RESULTSOf 399 patients with omphalocele, 89 had trisomy 13 or 18. The average birthweight was 2,449 g, and the average gestational age was 35 weeks; 65% had other congenital associated anomalies, including circulatory and chromosomal anomalies. About 85% of the patients received abdominoplasty. The median length of mechanical ventilation was 5 (0–30) days. The median length of stay (interquartile range) was 45 (21–94) days. Overall, 52% of the patients were discharged to home without home medical care; this percentage was 65% among those without trisomy 13 or 18. In-hospital mortality was 20% for the total sample of patients, while it was 49% for those with trisomy 13 or 18.CONCLUSIONSThe present study revealed the patient demographics, treatment practices, and discharge status of infants with omphalocele in Japan. This information is useful in aiding decision making on therapeutic strategies by medical staffs and the families of patients with omphalocele.
- 著者
- Michimasa Fujiogi Takaaki Konishi Nobuaki Michihata Yohei Hashimoto Hiroki Matsui Tetsuya Ishimaru Kiyohide Fushimi Hideo Yasunaga Jun Fujishiro
- 出版者
- Society for Clinical Epidemiology
- 雑誌
- Annals of Clinical Epidemiology (ISSN:24344338)
- 巻号頁・発行日
- pp.23004, (Released:2022-09-29)
Background: Little is known about perioperative outcomes after pediatric thyroidectomy. This study was performed to compare perioperative outcomes between children and adults undergoing thyroid cancer surgery using a nationwide inpatient database in Japan.Methods: Using the Japanese Diagnosis Procedure Combination database, we identified patients aged 0 to 40 years with thyroid cancer who underwent thyroidectomy from July 2010 to March 2020. To compare the occurrence of in-hospital morbidities including local complications (e.g., recurrent laryngeal nerve paralysis, postoperative bleeding), duration of anesthesia, postoperative length of stay, and total hospitalization costs between children (0–18 years) and adults (19–40 years), we used multivariable logistic regression analysis for the occurrence of in-hospital morbidities and linear regression for other outcomes. Results: For 16,016 eligible patients (666 children vs. 15,350 adults), no significant differences between the two groups were found in any in-hospital morbidity (5.4% vs. 5.9%; adjusted odds ratio [OR], 0.80; 95% confidence interval [CI], 0.57–1.14; P=0.23), local complications (5.0% vs. 5.5%; OR, 0.80; 95% CI, 0.55–1.15; P=0.22), recurrent laryngeal nerve paralysis (2.1% vs. 2.4%; OR, 0.78; 95% CI, 0.45–1.35; P=0.37), or postoperative bleeding (1.7% vs. 1.4%; OR, 0.99; 95% CI, 0.53–1.87; P=0.98). Children showed a longer duration of anesthesia (difference, 20 minutes; 95% CI, 13–27; P<0.001) and higher total costs (difference, 445 US dollars; 95% CI, 239–651; P<0.001) than adults.Conclusion: This large nationwide cohort study showed no significant difference in perioperative complications between children and adults undergoing thyroid cancer surgery.