数据库研究第八部分:结直肠癌术后风险与并发症

Database research partⅧ:postoperative risks and complications of colorectal cancer

目的分析当前版本华西肠癌数据库(Database from Colorectal Cancer,DACCA)中结直肠癌手术后的风险与并发症。方法本次数据分析选取的DACCA版本为2020年7月28日更新版,其中术后康复风险数据项目包括手术反应、体温、排气、疼痛和精神,并发症板块数据项目包括术后、近期和远期,对所选的数据项目进行统计学分析。结果本研究符合筛选条件的数据病案(数据行)总量为6422条,其中“手术反应”的有效数据共4185条(65.2%),“体温”的有效数据共3833条(59.7%),“排气”的有效数据共3835条(59.7%),“疼痛”的有效数据共3597条(56.0%),“精神”的有效数据共3551条(55.3%),“术前”、“术后”、“近期”和“远期”的有效数据均为6422条(100%)。“手术反应”中,结构化显示为“一般”的数据行数最多,有1517条(36.2%)。“体温”升高持续时间中结构化显示为“体温>37.5℃”0 d的数据行数最多,有1980条(51.7%)。“排气”中结构化显示为“3 d”的数据行数最多,有1675条(43.7%)。“疼痛”分级中结构化显示为“不明显”的数据行数最多,有2755条(76.6%)。“精神”中结构化显示为“较好”的数据行数最多,有2976条(83.8%)。“术前”中结构化显示为有术前并发症50条(0.8%);“术后”中结构化显示为有术后并发症595条(9.3%),其中以吻合口漏(80条,13.4%)、炎性肠梗阻(62条,10.4%)、肺部感染(57条,9.6%)和吻合口出血(56条,9.4%)较多;“近期”中结构化显示为无近期并发症6169条(96.1%);“远期”中结构化显示为无远期并发症6283条(97.8%)。结论通过DACCA数据库中真实世界数据展示的并发症变化,提示了术后风险关注点会伴随随访时间的延长,必须随之作出调整。对于并发症评估系统,需要建立相应的类型和风险相结合的完整并发症评估体系,才能真正开展有价值的并发症研究。

Objective To analyze the risks and complications after operation of colorectal cancer in the current version of Database from Colorectal Cancer(DACCA).Methods The DACCA version selected for this data analysis was the updated version on July 28th,2020.The data items included surgery reaction,body temperature,flatus,pain and mental status;preoperative complication,postoperative complication,short-term and long-term complication.The selected data items were statistically analyzed.Results The total number of medical records(data rows)that met the criteria was 6422,including 4185(65.2%)valid data on surgery reaction,3833(59.7%)valid data on body temperature,3835(59.7%)valid data on flatus,3597(56.0%)valid data on pain,3551(55.3%)valid data on mental status,6422(100%)valid data on preoperative complications,postoperative complications,short-term complications and long-term complications.In the surgical response,1517(36.2%)lines of data showed“normal”structure were the most.Among the days with elevated body temperature,the number of 0-day data lines with the structure of“body temperature>37.5℃”was the highest,with 1980(51.7%).In postoperative flatus,there were 1675(43.7%)data lines with the structure showing“3 days”.The largest number of rows(2755,76.6%)showed a structure that was“not obvious”in the pain scale.The mental status showed the highest number of“better”rows(2976,83.8%).There were 50 preoperative complications(0.8%).And 595 postoperative complications(9.3%),including anastomotic leakage(80,13.4%),inflammatory ileus(62,10.4%),pulmonary infection(57,9.6%),and anastomotic bleeding(56,9.4%),etc.There were 6169(96.1%)without short-term complication in structural form.There were 6283(97.8%)without longterm complications.Conclusions The changes in complications shown in the real world data from DACCA suggest that the focus of postoperative risks must be changed with the over the follow-up time.As for the complication evaluation system,it is necessary to establish a complete evaluation system combining the corresponding types and risks,to carry out valuable complication researches.