Inpatient survival after gastrectomy for gastric cancer in the 21st century

• Published in: The Journal of surgical research 2014-07, Vol.190 (1), p.72-78
• Main Authors: Wang, Han, MD, MPH, Pawlik, Timothy M., MD, MPH, PhD, Duncan, Mark D., MD, Hui, Xuan, MD, ScM, Selvarajah, Shalini, MD, MPH, Canner, Joseph K., MHS, Haider, Adil H., MD, MPH, Ahuja, Nita, MD, Schneider, Eric B., PhD
• Format: Article
• Language: English
• Subjects: Aged; Cross-Sectional Studies; Female; Gastrectomy; Gastrectomy - mortality; Gastric cancer; Hospital Mortality; Humans; Inpatients; Male; Retrospective Studies; Stomach Neoplasms - surgery; Surgery; Survival; Variation
• ISSN: 0022-4804; 1095-8673
• DOI: 10.1016/j.jss.2014.03.015

Abstract Background Surgical treatment for gastric cancer has evolved substantially. To understand how changes in patient- and hospital-level factors are associated with outcomes over the last decade, we examined a nationally representative sample. Methods Retrospective cross-sectional discharge data from the 2001–2010 Nationwide Inpatient Sample were analyzed using cross tabulation and multivariable regression modeling. Patients with a primary diagnosis of gastric cancer undergoing gastrectomy as primary procedure were included. We examined relationships between patient- and hospital-level factors, surgery type, and outcomes including in-hospital mortality and length of stay (LOS). Results A total of 67,327 patients with gastric cancer undergoing gastrectomy nationwide with complete information were included. Compared with patients treated in 2001, patients in 2010 were younger, more likely admitted electively, treated in a teaching hospital, or at an urban center. There was no difference in the type of procedure performed over time. Factors associated with an increased risk of in-hospital mortality included older age, male gender, and nonelective admission ( P