Short-Term Outcomes of Epidural Analgesia in Minimally Invasive Esophagectomy for Esophageal Cancer: Nationwide Inpatient Data Study in Japan.

Background: Studies have shown that epidural analgesia (EDA) is associated with a decreased risk of pneumonia and anastomotic leakage after esophagectomy, and several guidelines strongly recommend EDA use after esophagectomy. However, the benefit of EDA use in minimally invasive esophagectomy (MIE) remains unclear.

Objective: The aim of this retrospective study was to compare the short-term outcomes between patients with and without EDA undergoing MIE for esophageal cancer.

Association between intravenous immunoglobulin dose and outcomes in patients with acute Kawasaki disease.

The most effective dosage of intravenous immunoglobulin (IVIG) to prevent coronary artery abnormalities (CAAs) in patients with acute Kawasaki disease (KD) remains unknown. This study aimed to identify the appropriate dose of IVIG to be administered to patients with acute KD, using a national inpatient database in Japan. We used the Diagnostic Procedure Combination database to identify KD patients treated with IVIG between 2010 and 2020.

Surgical and obstetric outcomes of breast cancer surgery during pregnancy: a nationwide database study in Japan.

Purpose: Although the incidence of breast cancer during pregnancy is increasing, little is known about short-term outcomes following breast cancer surgery during pregnancy. We aimed to compare the characteristics and outcomes of breast cancer surgery with and without pregnancy, and describe the obstetric outcomes following surgery.

Methods: The data of 249,257 female patients aged < 60 years who underwent breast cancer surgery between July 2010 and March 2020 were analyzed using a nationwide Japanese database; we generated a 1:10 matched-pair cohort (260 and 2597 patients with and without pregnancy, respectively) matched according to age and treatment year.

Postoperative cerebral infarction risk is related to lobectomy site in lung cancer: a retrospective cohort study of nationwide data in Japan.

Objectives: To determine the incidence of cerebral infarction after lobectomy at different sites using inpatient data from a diagnosis procedure combination database.

Design: Retrospective cohort study.

Setting: Data were retrieved from the Japanese diagnosis procedure combination inpatient database for patients who underwent lobectomies for lung cancer between April 2018 and March 2020.

Evaluating the daily life of child and adolescent psychiatric outpatients during temporary school closure over COVID-19 pandemic: A single-center case-control study in Japan.

This study evaluated the clinical characteristics of mental health of child and adolescent psychiatric patients during temporary school closure throughout the coronavirus 2019 (COVID-19) pandemic in Japan using the Questionnaire - Children with Difficulties (QCD) and other useful psychological rating scales. The participants were those who visited the Department of Child and Adolescent Psychiatry, Kohnodai Hospital. From those 1,463 participants, case and control groups were selected: 92 patients who visited the hospital during the temporary school closure from March 2020 to May 2020 (case group) and randomly sampled sex- and age-matched 92 patients during the pre-COVID period from April 2017 to March 2020 (control group).

Comparison of short-term outcomes between pedicled- and free-flap autologous breast reconstruction: a nationwide inpatient database study in Japan.

Background: Despite the increasing popularity of autologous breast reconstruction, limited evidence is available. The aim of the present study was to compare the short-term outcomes of pedicled- and free-flap breast reconstructions.

Methods: Using a nationwide Japanese inpatient database, we identified 13,838 patients who underwent breast reconstruction for breast cancer (July 2010-March 2020) using a pedicled or free-flap (pedicled- and free-flap groups, n = 8279 and 5559, respectively).

Temporal trends of medical cost and cost-effectiveness in sepsis patients: a Japanese nationwide medical claims database.

Background: Sepsis is the leading cause of death worldwide. Although the mortality of sepsis patients has been decreasing over the past decade, the trend of medical costs and cost-effectiveness for sepsis treatment remains insufficiently determined.

Methods: We conducted a retrospective study using the nationwide medical claims database of sepsis patients in Japan between 2010 and 2017.

Impact of Prophylactic Corticosteroid Use on In-hospital Mortality and Respiratory Failure After Esophagectomy for Esophageal Cancer: Nationwide Inpatient Data Study in Japan.

Objective: To assess the effect of preoperative prophylactic corticosteroid use on short-term outcomes after oncologic esophagectomy.

Background: Previous studies have shown that prophylactic corticosteroid use may decrease the risk of respiratory failure following esophagectomy by attenuating the perioperative systemic inflammation response. However, its effectiveness has been controversial, and its impact on mortality remains unknown.

Preoperative arterial embolization and wound complications after resection of malignant bone tumor in the pelvis: a nationwide database study.

Background: Massive intraoperative blood loss is common in pelvic malignant bone tumor surgery, and preoperative arterial embolization may be used in selected cases. Preoperative arterial embolization reportedly increases wound complications in pelvic fracture surgery, but little evidence is available regarding pelvic bone tumor surgery.

Methods: Using a Japanese nationwide database (Diagnosis Procedure Combination database), we searched for patients who underwent pelvic malignant bone tumor surgery between July 2010 and March 2018.

Longer Daily Duration of Supervised Rehabilitation after Laparoscopic Surgery for Colorectal Cancer Improves Activities of Daily Living.

Objective: To evaluate the effect of a supervised rehabilitation programme with longer hours per day on activities of daily living after laparoscopic surgery for colorectal cancer.

Design: This study represents retrospective observational use of nationwide administrative data.

Patients: Eligible patients (n = 8,633) were first diagnosed with colorectal cancer between 1 April 2017 and 31 March 2018, underwent laparoscopicassisted colorectal resection, and began rehabilitation within 3 days of surgery.

Laparoscopic versus open distal pancreatectomy with or without splenectomy: A propensity score analysis in Japan.

Background: Although the laparoscopic approach has been applied to distal pancreatectomy, its benefits with regard to the short-term outcomes of distal pancreatectomy remain unclear.

Materials And Methods: Using a Japanese nationwide inpatient database, we identified patients who underwent laparoscopic (n = 6647) and open (n = 21,843) distal pancreatectomy between July 2012 and March 2020. We conducted a 1:2 propensity score-matched analysis with adjustment for background characteristics (e.

Comparison of liposomal amphotericin B alone and in combination with flucytosine in the treatment of non-HIV Cryptococcal meningitis: A nationwide observational study.

Background: Cryptococcal meningitis (CM) is an opportunistic infectious disease that occurs in immunocompromised hosts, not only in patients living with HIV, but also in patients without HIV. The evidence regarding the treatment for CM in patients without HIV is mainly found in small retrospective studies and is extremely limited.

Objectives: In the present study, we compared the efficacy of liposomal amphotericin B (L-AMB) alone and in combination with flucytosine (5-FC) for the induction treatment of CM in patients without HIV.

Association between comprehensive geriatric assessment and polypharmacy at discharge in patients with ischaemic stroke: A nationwide, retrospective, cohort study.

Background: Polypharmacy and its adverse drug events are a major healthcare challenge related to falls, hospitalisations and mortality. Comprehensive geriatric assessment (CGA) may contribute to polypharmacy improvement, however, there is no clear evidence so far.

Methods: Using a national inpatient database in Japan from April 1, 2014 to March 31, 2018, we investigated the association between CGA and polypharmacy.

Temporal trends in clinical characteristics and in-hospital mortality among patients with COVID-19 in Japan for waves 1, 2, and 3: A retrospective cohort study.

Introduction: Little information is available on the temporal trends in the clinical epidemiology and in-hospital mortality of patients with coronavirus disease 2019 (COVID-19) in Japan for waves 1, 2, and 3.

Methods: A national claims database was used to analyze the time trends in admission, medical procedure, and in-hospital mortality characteristics among patients with COVID-19. Patients who were ≥18 years and discharged from January 1, 2020 to February 28, 2021 were included.

Cost-effectiveness analysis of trastuzumab monotherapy versus adjuvant chemotherapy plus trastuzumab in elderly patients with HER2-positive early breast cancer.

Background: In elderly patients with human epidermal growth factor 2-positive breast cancer, adjuvant chemotherapy was associated with decreased quality of life, with relatively small benefits for prognosis. We examined the cost-effectiveness of trastuzumab monotherapy versus adjuvant chemotherapy plus trastuzumab in elderly patients with human epidermal growth factor 2-positive breast cancer.

Methods: A Markov model was developed to evaluate the costs and benefits of trastuzumab monotherapy over adjuvant chemotherapy plus trastuzumab for elderly patients with human epidermal growth factor 2-positive breast cancer.

Economic and clinical burden from carbapenem-resistant bacterial infections and factors contributing: a retrospective study using electronic medical records in Japan.

Background: Antimicrobial resistance is a major threat to global health and the world economy. The economic burden of carbapenem-resistant infections has not previously been evaluated. We aimed to compare the potential economic burden and clinical outcomes between carbapenem-resistant infections and carbapenem-susceptible infections in Japan.

Early electroconvulsive therapy in patients with bipolar depression: A propensity score-matched analysis using a nationwide inpatient database.

Objectives: Electroconvulsive therapy (ECT) is a widely used treatment for bipolar depression; however, evidence of its effectiveness is not sufficient. This study therefore aimed to evaluate whether early ECT is associated with reduced length of hospital stay.

Methods: In this retrospective cohort study using the Japanese Diagnosis Procedure Combination database, we identified patients admitted for bipolar depression between April 2010 and March 2018.

Perioperative Complications of Anterior Decompression with Fusion in Degenerative Cervical Myelopathy-A Comparative Study between Ossification of Posterior Longitudinal Ligament and Cervical Spondylotic Myelopathy Using a Nationwide Inpatient Database.

For ossification of the posterior longitudinal ligament (OPLL) and cervical spondylotic myelopathy (CSM), anterior decompression with fusion (ADF) can accurately achieve spinal decompression. However, the difference in perioperative complications in ADF between OPLL and CSM is poorly described. This study aimed to investigate the perioperative complication rates of patients with degenerative cervical myelopathy undergoing ADF, represented by OPLL and CSM, using a large national inpatient database.

Pandemic-resilient target setting in colorectal cancer screening for vulnerable older population.

Background: Colorectal cancer screening (CRCS) needs to be pandemic-resilient to avoid long-lasting shutdowns; however, realistic participation target remains unelucidated. This study aimed to identify the lowest acceptable participation rate in CRCS during a pandemic, focusing on vulnerable older populations who require urgent intervention.

Methods: This nationwide cross-sectional study included 80,946 inpatients aged 70-85 years who were first diagnosed with colorectal cancer (CRC) after 70 years of age, between April 1, 2014 and March 31, 2019, in Japan.

Postoperative outcomes of cancer surgery in patients with and without kidney failure with dialysis therapy: a matched-pair cohort study.

Background: The difference in outcomes of cancer surgery between patients with and without kidney failure with dialysis therapy (KFDT) remains uncertain.

Methods: Using 2010-18 data in a national inpatient database in Japan, we identified patients who had undergone resection of colorectal, lung, gastric or breast cancer. We matched selected patient characteristics, type of cancer, surgical procedure and hospital of up to four patients without KFDT to each patient with KFDT.