Postoperative mortality analysis on nationwide data from diagnosis procedure combination database in Japan

Area of Science:

• Healthcare research
• Public health surveillance
• Surgical outcomes analysis

Background:

• Postoperative mortality is a critical indicator of surgical care quality.
• Understanding regional and temporal variations in surgical mortality is essential for healthcare policy.
• The diagnosis procedure combination (DPC) database offers a valuable resource for nationwide healthcare analysis.

Purpose of the Study:

• To investigate nationwide postoperative mortality across all surgeries at the prefectural level in Japan.
• To evaluate temporal changes and regional disparities in surgical mortality using a national DPC database.
• To identify specific surgical procedures with significant regional variations in mortality.

Main Methods:

• Utilized a nationwide diagnosis procedure combination (DPC) database from Japan.
• Analyzed in-hospital mortality data for representative surgeries from fiscal years 2011 to 2018.
• Calculated mortality rates at the prefectural level, presenting data with a minimum of 10 aggregated cells.

Main Results:

• The analysis included 474,154 records covering approximately 2,000 surgical codes.
• Mortality analysis was feasible for 16,890 data cells with over 10 recorded mortalities.
• Observed regional differences and declining mortality trends in specific procedures like artificial head insertion, cerebral aneurysm neck clipping, bypass grafting, and tracheotomy.

Conclusions:

• Significant regional variations and temporal trends exist in postoperative surgical mortality in Japan.
• The findings underscore the importance of considering geographical factors and quality of care in surgical outcomes.
• Further research should incorporate contextual factors to provide a comprehensive understanding of surgical mortality data.