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Comorbidity and the risk of anastomotic leak in Chinese patients with colorectal cancer undergoing colorectal surgery

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International Journal of Colorectal Disease Aims and scope Submit manuscript

Abstract

Purpose

Comorbidities had considerable effects on the prognosis in patients with colorectal cancer (CRC). The primary aim of the present study was to examine the influence of comorbidity on the risk of anastomotic leak (AL) in patients with CRC who underwent surgical resection.

Methods

Using the electronic Hospitalization Summary Reports in the top-ranked public hospitals in China, we identified 11,397 patients with CRC undergoing resection surgery from 2013 through 2015. We estimated the risk of AL according to Charlson Comorbidity Index (CCI) score using logistic regression analysis, adjusting for age, sex, and geographic regions.

Results

The incidence rate of AL in the study population was 1.8% (204/11,397). Multivariable analyses identified male sex and CCI score as independent risk factors for AL. The CCI score had a positive graded association with the risk of AL (P for trend = 0.006). The risk increased by an estimated 10.2% (odds ratio [OR], 1.10; 95% confidence interval [CI], 1.03–1.18) for each additional 1 point in the CCI score. After adjusting for potential confounders, patients with a CCI score ≥3 had 1.82 times (95% CI, 1.24–2.69) higher risk of AL compared with patients with a CCI score of 0.

Conclusion

The findings suggested that CCI score was an independent risk factor for the development of AL in Chinese patients with CRC who underwent surgical resection.

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Acknowledgements

This research work was funded by the National Natural Science Foundation of China (Grant No. 71402003). The funding sources had no involvement in the study design; the collection, analysis, and interpretation of data; the writing of the report; and the decision to submit the article for publication.

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Authors and Affiliations

  1. Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No.38 Xueyuan Road, Beijing, 100191, China

    Yaohua Tian

  2. Medical Informatics Center, Peking University, No.38 Xueyuan Road, Beijing, 100191, China

    Beibei Xu, Guopei Yu & Hui Liu

  3. National Healthcare Data Center, No.38 Xueyuan Road, Beijing, 100191, China

    Yan Li & Hui Liu

  4. Hospital Administration Department, Peking University, No.38 Xueyuan Road, Beijing, 100191, China

    Yan Li

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  1. Yaohua Tian
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  2. Beibei Xu
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  3. Guopei Yu
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  4. Yan Li
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  5. Hui Liu
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Contributions

H.L. contributed to the study concept. H.L. had full access to all the data in the study and take responsibility for the integrity of the data. H.L. and B.X. contributed to the statistical analysis and tables’ development of this article. Y.H.T., G.P.Y., and Y.L. interpreted the findings and drafted the article. All the authors contributed to the critical revision of the article for important intellectual content.

Corresponding author

Correspondence to Hui Liu.

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The authors have no conflicts of interest to disclose.

Additional information

Yan Li and Hui Liu are affiliated to National Center for Medical Service Administration.

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Tian, Y., Xu, B., Yu, G. et al. Comorbidity and the risk of anastomotic leak in Chinese patients with colorectal cancer undergoing colorectal surgery. Int J Colorectal Dis 32, 947–953 (2017). https://doi.org/10.1007/s00384-017-2798-4

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