| アブストラクト | AIMS/INTRODUCTION: Little is known about the effect of diabetologists on perioperative complication risk. Given that colorectal cancer surgery is known to carry a high complication risk among patients with diabetes, this study aimed to examine the association between the presence of diabetologists at the facility level and the risk of perioperative complications during colorectal cancer surgery. MATERIALS AND METHODS: In this retrospective cohort study, we sourced the number of board-certified diabetologists from the Japan Diabetes Society and combined it with Diagnosis Procedure Combination (DPC) data, encompassing receipt data from acute care facilities across Japan. We used a modified Poisson model to estimate the risk of perioperative complications associated with the presence of diabetologists by adjusting for potential confounding patient and facility factors. RESULTS: Analysis included 887 facilities, of which 299 (34%) had no diabetologists. A total of 24,714 patients with diabetes underwent colorectal cancer surgery between April 2018 and March 2019, with a median age of 73 years (interquartile range: 67-79 years) and 16,274 (66%) men. There were 3,165 (13%) perioperative complications. After adjustment, the risk of perioperative complications was 0.86 times (95% confidence interval: 0.77-0.96) lower in centers with at least one diabetologist than in those without a diabetologist. CONCLUSIONS: Our study suggests that the presence of a diabetologist may be important in reducing the risk of perioperative complications during colorectal cancer surgery in patients with diabetes. Future studies factoring in other facility factors and surgical types may be required to further validate our findings. |
|---|
| 投稿者 | Shikata, Masataka; Goto, Atsushi; Shimizu, Sayuri; Kamei, Nozomu; Chujo, Daisuke; Endo, Itaru; Shimada, Akira; Fushimi, Kiyohide; Ueki, Kohjiro; Tobe, Kazuyuki |
|---|
| 組織名 | Department of Public Health, School of Medicine Yokohama City University,;Yokohama, Japan.;First Department of Internal Medicine, University of Toyama, Toyama, Japan.;Department of Health Data Science, Yokohama City University, Yokohama, Japan.;Department of Endocrinology and Metabolism, Hiroshima Red Cross Hospital &;Atomic-Bomb Survivors Hospital, Hiroshima, Japan.;Department of Diabetes, Metabolism, and Endocrinology, International University;of Health and Welfare, Ichikawa, Japan.;Department of Gastroenterological Surgery, Yokohama City University Graduate;School of Medicine, Yokohama, Japan.;Department of Endocrinology and Diabetes, School of Medicine, Saitama Medical;University, Saitama, Japan.;Department of Health Informatics and Policy, Graduate School of Medical and;Dental Sciences, Institute of Science Tokyo, Tokyo, Japan.;Department of Molecular Diabetic Medicine, Diabetes Research Center, Research;Institute, National Center for Global Health and Medicine, Tokyo, Japan.;Research Center for Pre-Disease Science, Faculty of Medicine, University of;Toyama, Toyama, Japan. |
|---|
