- 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.
- 著者
- Yohei Hashimoto Hideo Yasunaga
- 出版者
- Society for Clinical Epidemiology
- 雑誌
- Annals of Clinical Epidemiology (ISSN:24344338)
- 巻号頁・発行日
- vol.4, no.4, pp.101-109, 2022 (Released:2022-10-03)
- 参考文献数
- 35
- 被引用文献数
- 4
Propensity score analysis has been widely used in observational studies to make a causal inference. This study introduces three assumptions for causal inferences—conditional exchangeability, positivity, and consistency—and five steps for propensity score (PS) analysis—1) construct appropriate PS models, 2) check overlap in PS, 3) apply appropriate weighting (inverse probability of treatment weighting, standardized mortality ratio weighting, matching weights, and overlap weights) or matching methods according to the target of inference, 4) check the balance of covariates, and 5) estimate the effect of exposure appropriately. Finally, the advantages of PS analyses over conventional multivariable regression are discussed.