Scholarlink

Background <p>Pancreaticoduodenectomy is the only curative treatment for pancreatic cancer, though it is an invasive procedure, with a high perioperative mortality rate, which may differ by region. The objectives of this study are to 1) investigate the risk of in-hospital mortality after pancreaticoduodenectomy in urban and rural hospitals, and 2) investigate its differences, stratified by age groups and hospital volume.</p> Methods <p>This study analyzed data from 86,339 patients who underwent pancreaticoduodenectomy from a Japanese nationwide database between 2010 and 2021. Hospitals were classified as urban if located in cities with ≥ 500,000 residents or in municipalities where ≥ 1.5% of residents commute to such cities, and all others were classified as rural. The primary outcome was in-hospital mortality within 90&#xa0;days after pancreaticoduodenectomy. Logistic regression was applied.</p> Results <p>The risk for in-hospital mortality within 90&#xa0;days after pancreaticoduodenectomy was significantly higher for patients in rural hospitals than those in urban hospitals (OR 1.17 [1.04–1.31]). Stratified analysis by age groups showed rural location was a significantly higher risk for patients ≧80&#xa0;years old (OR 1.41 [1.11–1.80]), whereas there was no significant difference among patients aged ≤ 79&#xa0;years. Stratified analysis by hospital volume and age groups showed that rural location was a significantly higher risk for patients ≧80&#xa0;years old in low-volume hospitals (OR 1.43 [1.09–1.87]), whereas that was not significant for patients in high-volume hospitals.</p> Conclusions <p>The risk for in-hospital mortality was higher for rural hospitals than urban. Patients aged ≥ 80&#xa0;years old in low-volume rural hospitals represented the highest-risk subgroup.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Regional differences for the risk of in-hospital mortality after pancreaticoduodenectomy: a cross-sectional study analyzing data from a Japanese nationwide database including 86,339 patients

  • 期刊论文

  • 发表日期：

    2026年3月2日

查看全文
  • Teruchika Koyama,
  • Nobutoshi Nawa,
  • Hisaaki Nishimura,
  • Mariko Hanafusa,
  • Keiichi Akahoshi,
  • Hiroki Ueda,
  • Kiyohide Fushimi,
  • Takeo Fujiwara

摘要

Background

Pancreaticoduodenectomy is the only curative treatment for pancreatic cancer, though it is an invasive procedure, with a high perioperative mortality rate, which may differ by region. The objectives of this study are to 1) investigate the risk of in-hospital mortality after pancreaticoduodenectomy in urban and rural hospitals, and 2) investigate its differences, stratified by age groups and hospital volume.

Methods

This study analyzed data from 86,339 patients who underwent pancreaticoduodenectomy from a Japanese nationwide database between 2010 and 2021. Hospitals were classified as urban if located in cities with ≥ 500,000 residents or in municipalities where ≥ 1.5% of residents commute to such cities, and all others were classified as rural. The primary outcome was in-hospital mortality within 90 days after pancreaticoduodenectomy. Logistic regression was applied.

Results

The risk for in-hospital mortality within 90 days after pancreaticoduodenectomy was significantly higher for patients in rural hospitals than those in urban hospitals (OR 1.17 [1.04–1.31]). Stratified analysis by age groups showed rural location was a significantly higher risk for patients ≧80 years old (OR 1.41 [1.11–1.80]), whereas there was no significant difference among patients aged ≤ 79 years. Stratified analysis by hospital volume and age groups showed that rural location was a significantly higher risk for patients ≧80 years old in low-volume hospitals (OR 1.43 [1.09–1.87]), whereas that was not significant for patients in high-volume hospitals.

Conclusions

The risk for in-hospital mortality was higher for rural hospitals than urban. Patients aged ≥ 80 years old in low-volume rural hospitals represented the highest-risk subgroup.