机构：[1]Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Gastrointestinal Surgery, Peking University Cancer Hospital and Institute, Beijing, China,[2]School of Statistics and Mathematics, Central University of Finance and Economics, Beijing, China,[3]Center of Minimally Invasive Gastrointestinal Surgery, Shanxi Provincial Cancer Hospital, Taiyuan, China,[4]Department of General Surgery, Fudan University Zhongshan Hospital, Shanghai, China,[5]Department of General Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, China,[6]Department of General Surgery, The Affiliated Hospital of Qingdao University, Qingdao, China,[7]Department of Gastric Cancer and Soft Tissue Sarcomas, Fudan University Shanghai Cancer Hospital, Shanghai, China,[8]Department of General Surgery, People’s Liberation Army General Hospital, People’s Liberation Army (PLA) Army General Hospital, Beijing, China,[9]Department of Gastrointestinal Surgery, Harbin Medical University Cancer Hospital, Harbin, China,[10]Department of General Surgery, Ruijin Hospital, Shanghai Jiao Tong University, Shanghai, China,[11]Department of General Surgery, Henan Cancer Hospital, Zhengzhou, China,外科第二医学部普外科河南省肿瘤医院[12]Department of General Surgery, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China,江苏省人民医院[13]Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou, China,[14]Department of Gastrointestinal Surgery, The First Hospital of Jilin University, Changchun, China,[15]Department of Gastric Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China,[16]Department of General Surgery, The First Affiliated Hospital of Xi’an Jiaotong Hospital, Xi’an, China,[17]Department of Gastrointestinal Surgery, West China Hospital, Chengdu, China,四川大学华西医院[18]Department of General Surgery, The First Affiliated Hospital of Dalian Medical University, Dalian, China,外科科室普外科大连医科大学附属第一医院[19]Department of Gastrointestinal Surgery, Nanjing General Hospital, Nanjing, China,[20]Department of General Surgery, The First Hospital Affiliated Hospital to Army Medical University (AMU) (Southwest Hospital), Chongqing, China,[21]Department of General Surgery, Nanfang Hospital, Guangzhou, China,[22]Department of General Surgery, Weifang People’s Hospital, Weifang, China,[23]Department of Gastrointestinal Surgery, First Affiliated Hospital of Kunming Medical University, Kunming, China,外科科室普通外科普通外一科(胃肠与疝外科)昆明医科大学附属第一医院[24]Department of General Surgery, Guangdong General Hospital, Guangzhou, China,外科科室普通外科广东省人民医院[25]Department of General Surgery, Affiliated Hospital of Zunyi Medical University, Zunyi, China,[26]Department of General Surgery, Penglai People’s Hospital, Penglai, China,[27]Centre for Global Health Research, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, United Kingdom
Background: The objective of this study is to identify independent risks and protective factors and to construct a mortality prediction model for gastrectomy in the Chinese population. Study design: This is a population-based prospective cohort at an institutional level. Seventy-two participating hospitals reported their annual gastrectomy data between 2014 and 2016, while 44 variables covering the institution and surgical information were included in the analysis. We used R software to encode and complete data pre-processing. The first difference model was applied to build the risk model. Data from 2014 and 2015 were assigned to risk model development, while data from 2016 was used for validation. Results: In the included centers with 94,277 gastric cancer cases, the in-hospital mortality rate was 0.32%. The regression model revealed that provinces with low-middle GDP, hospitals with annual gastrectomy volume between 100 and 500, greater volume of urgent surgeries performed, larger proportion of males, and a higher proportion of liver metastasis were independent risk factors for mortality following gastric surgeries, while higher laparoscopic resection volume, greater volume of distal gastrectomy with B2 reconstruction, and larger proportion of palliative surgery were independent protective factors (p< 0.05, respectively). In the prediction test, themean square error of the training set was 0.948, while that of the test set was 0.728, demonstrating the effectiveness of this model. Conclusions: We constructed the first mortality risk prediction model for gastric cancer surgery in the Chinese population. The identified risk factors will help with the therapy selection, while further informing Chinese medical policy decision-makers.
基金：
Beijing Municipal Science & Technology project, Beijing Municipal Science & Technology CommissionBeijing Municipal Science & Technology Commission [D131100005313010]; National Key Technology Research and Development Program of the Ministry of Science and Technology of ChinaNational Key Technology R&D Program [2014BAI09B02]
第一作者机构：[1]Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Gastrointestinal Surgery, Peking University Cancer Hospital and Institute, Beijing, China,
共同第一作者：
通讯作者：
推荐引用方式(GB/T 7714)：
Wu Zhouqiao,Cheng Huimin,Shan Fei,et al.In-Hospital Mortality Risk Model of Gastric Cancer Surgery: Analysis of a Nationwide Institutional-Level Database With 94,277 Chinese Patients[J].FRONTIERS IN ONCOLOGY.2019,9:doi:10.3389/fonc.2019.00846.
APA：
Wu, Zhouqiao,Cheng, Huimin,Shan, Fei,Ying, Xiangji,Miao, Rulin...&China Gastrointestinal Cancer Surgery Union.(2019).In-Hospital Mortality Risk Model of Gastric Cancer Surgery: Analysis of a Nationwide Institutional-Level Database With 94,277 Chinese Patients.FRONTIERS IN ONCOLOGY,9,
MLA：
Wu, Zhouqiao,et al."In-Hospital Mortality Risk Model of Gastric Cancer Surgery: Analysis of a Nationwide Institutional-Level Database With 94,277 Chinese Patients".FRONTIERS IN ONCOLOGY 9.(2019)
