Database research part Ⅲ: comorbidities and preoperative physical status of colorectal cancer_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

WANG Xiaodong ¹ , LIU Jianbo ^1,2 , ZHANG Shi ^1,2 ,  LI Li ¹

1. Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu 610041, P. R. China;
2. West China School of Medicine, Sichuan University, Chengdu 610041, P. R. China;

Corresponding?author：

LI Li, Email: drlili116@126.com

Keywords：

colorectal cancer; database; bigdata; comorbidity; physical status

DOI：

10.7507/1007-9424.201907010

Video：

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Objective Based on the current version of Database from Colorectal Cancer (DACCA), we aimed to analyze the comorbidities and preoperative physical status of colorectal cancer patients.Methods The DACCA version selected for this data analysis was updated on May 9, 2019. The data items included: surgical comorbidities and classified by systems, surgical history, pelvic disease history, medical comorbidities, and some important subdivision types, infectious disease status, allergic history, nutrition risk screening 2002 (NRS2002) score, amount of weight loss after illness, anemia, low protein status, preoperative ascites status, preoperative pleural effusion status, immune system disease and immunocompromised status, and preoperative nutritional support. Characteristic analysis was performed on each selected data item.Results A total of 6 166 admitted data were filtered from the DACCA database. Among them, surgical comorbidities, surgical history, medical comorbidities, and allergy history had 6 166 admitted data, and weight loss had admitted 4 703. There were 2 923 (47.4%) with surgical comorbidities. According to the system, the most common one was digestive system (2 005, 68.6%), and the least one was skin tissue system (24, 0.8%). There were 4 361 (70.7%) patients without surgical history and 1 805 (29.3%) patients had surgical history. There were 2 397 (38.9%) patients without medical comorbidities and 3 769 (61.1%) had medical comorbidities, of which pneumonia/pulmonary infection/chronic bronchopneumonia/lung indeterminate nodules were the most common(2 330, 37.8%), the least was cerebral infarction (unspecified type, 63, 1.0%). There were 5 813 (94.3%) without allergy history and 353 (5.7%) had allergy history. According to the NRS2002 nutrition screening criteria, the scores ranged from 1 to 7 points, with an average of 1.22 points, which could be classified as non-nutrition risk (5 279, 85.6%, included 1 point of 4 310, 2 points of 969), nutritional risk (887, 14.4%, included 3 points of 415, 4 points of 358, 5 points of 100, 6 points of 12, and 7 points of 2), the result of linear regression analysis of NRS2002 scores with the trend of the year showed that: ?=0.000 2x–6.275 8, R²=0.716 2, P<0.001. A total of 2 840 (60.4%) had no weight loss while 1 863 (39.6%) had, and weight loss with the trend of year were analyzed by linear regression analysis: ?=0.000 2x–3.956, R²=0.685 7, P<0.001. The number of cases of other physical status and the proportion of valid data were anemia (1 194, 33.1%), preoperative ascites (1829, 51.7%), preoperative pleural effusion (171, 5.7%), hypoproteinemia (1 206, 33.6%), immune system disease and immunocompromised status (495, 56.6%), and nutritional support (824, 25.0%).Conclusions Through the analysis of the DACCA database, nearly 1/2 of colorectal cancer surgery patients have surgical comorbidities before surgery, more than 1/2 of the patients have medical comorbidities, and the types of diseases are various. Preoperative nutritional status in patients with colorectal cancer also shows certain characteristics, suggesting the state of preoperative risk. These data will provide a detailed big data basis for future preoperative risk assessment of colorectal cancer.

Citation： WANG Xiaodong, LIU Jianbo, ZHANG Shi, LI Li. Database research part Ⅲ: comorbidities and preoperative physical status of colorectal cancer. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2019, 26(8): 985-991. doi: 10.7507/1007-9424.201907010 Copy

1.	汪曉東, 安麗珉, 李立. 數據庫研究第二部分: 結直腸癌的住院流程管理. 中國普外基礎與臨床雜志, 2019, 26(4): 469-475.
2.	汪曉東, 李立. 數據庫建設第一部分: 個人數據的標簽與結構化. 中國普外基礎與臨床雜志, 2019, 26(3): 335-342.
3.	汪曉東, 李希, 何欣林, 等. 數據庫研究第一部分:區域性醫療中心的結直腸癌與人群特征. 中國普外基礎與臨床雜志, 2019, 26(2): 212-220.
4.	汪曉東, 呂沂, 黃明君, 等. 數據庫建設第二部分: 結直腸癌住院流程管理的標簽與結構化. 中國普外基礎與臨床雜志, 2019, 26(7): 852-855.
5.	劉健博, 呂炘沂, 鄒雨恒, 等. 多周期新輔助化療聯合阿帕替尼對進展期直腸癌的療效評價—基于DACCA數據庫的輔助研究. 中國普外基礎與臨床雜志, 2019, 26(6): 728-734.
6.	于瑞璇, 何欣林, 張秋露, 等. 華西DACCA的輔助研究: 單獨的新輔助化療不會影響直腸癌術后近期的肛門功能. 中國普外基礎與臨床雜志, 2019, 26(5): 595-601.
7.	Isik O, Okkabaz N, Hammel J, et al. Preoperative functional health status may predict outcomes after elective colorectal surgery for malignancy. Surg Endosc, 2015, 29(5): 1051-1056.
8.	Lin J, Peng J, Qdaisat A, et al. Severe weight loss during preoperative chemoradiotherapy compromises survival outcome for patients with locally advanced rectal cancer. J Cancer Res Clin Oncol, 2016, 142(12): 2551-2560.
9.	Bagnall NM, Pring ET, Malietzis G, et al. Perioperative risk prediction in the era of enhanced recovery: a comparison of POSSUM, ACPGBI, and E-PASS scoring systems in major surgical procedures of the colorectal surgeon. Int J Colorectal Dis, 2018, 33(11): 1627-1634.
10.	Baré M, Alcantara MJ, Gil MJ, et al. Validity of the CR-POSSUM model in surgery for colorectal cancer in Spain (CCR-CARESS study) and comparison with other models to predict operative mortality. BMC Health Serv Res, 2018, 18(1): 49.
11.	Prabakaran V, Thangaraju T, Mathew AC, et al. CR-possum-can it be used to predict morbidity? A single-centre retrospective study. Indian J Surg Oncol, 2019, 10(1): 174-179.
12.	Yan J, Wang YX, Li ZP. Predictive value of the POSSUM,p-POSSUM, cr-POSSUM, APACHE Ⅱ and ACPGBI scoring systems in colorectal cancer resection. J Int Med Res, 2011, 39(4): 1464-1473.
13.	Ren L, Upadhyay AM, Wang L, et al. Mortality rate prediction by physiological and operative severity score for the enumeration of mortality and morbidity (POSSUM), portsmouth POSSUM and colorectal POSSUM and the development of new scoring systems in Chinese colorectal cancer patients. Am J Surg, 2009, 198(1): 31-38.
14.	Tekkis PP, Poloniecki JD, Thompson MR, et al. Operative mortality in colorectal cancer: prospective national study. BMJ, 2003, 327(7425): 1196-1201.
15.	曹霖, 汪曉東, 陳珊珊, 等. ACPGBI結直腸癌術后風險評估模型臨床應用的初步探索. 中國普外基礎與臨床雜志, 2008, 15(9): 646-651, 655.
16.	汪曉東, 曹霖, 李立. 結直腸癌術后風險預測模型CCF-CCM的應用進展. 中國現代醫學雜志, 2012, 22(2): 91-94.
17.	汪曉東, 曹霖, 呂東昊, 等. 多學科協作診治模式下結直腸癌新輔助化療聯合手術的風險評估研究. 中國普外基礎與臨床雜志, 2008, 15(9): 692-696.
18.	Stommel MW, de Wilt JH, ten Broek RP, et al. Prior abdominal surgery jeopardizes quality of resection in colorectal cancer. World J Surg, 2016, 40(5): 1246-1254.
19.	Ishida H, Ishiguro T, Ishibashi K, et al. Impact of prior abdominal surgery on curative resection of colon cancer via minilaparotomy. Surg Today, 2011, 41(3): 369-376.
20.	Ma RCW. Epidemiology of diabetes and diabetic complications in China. Diabetologia, 2018, 61(6): 1249-1260.
21.	Li Y, Yang L, Wang L, et al. Burden of hypertension in China: a nationally representative survey of 174,621 adults. Int J Cardiol, 2017, 227: 516-523.
22.	Cramer L, Hildebrandt B, Kung T, et al. Cardiovascular function and predictors of exercise capacity in patients with colorectal cancer. J Am Coll Cardiol, 2014, 64(13): 1310-1319.
23.	Sagawa M, Yoshimatsu K, Yokomizo H, et al. Pulmonary dysfunction function and poor nutritional status are risk factors for remote infections following surgery for colorectal cancer. J Nippon Med Sch, 2018, 85(4): 208-214.
24.	Wang Y, Zheng J, Gao Z, et al. Investigation on nutritional risk assessment and nutritional support status of surgical patients with colorectal cancer. J BUON, 2018, 23(1): 62-67.
25.	Reischl S, Wilhelm DF, Neumann PA, et al. Peri- and postoperative nutrition in colorectal cancer patients. Ther Umsch, 2018, 75(10): 642-648.

1. 汪曉東, 安麗珉, 李立. 數據庫研究第二部分: 結直腸癌的住院流程管理. 中國普外基礎與臨床雜志, 2019, 26(4): 469-475.
2. 汪曉東, 李立. 數據庫建設第一部分: 個人數據的標簽與結構化. 中國普外基礎與臨床雜志, 2019, 26(3): 335-342.
3. 汪曉東, 李希, 何欣林, 等. 數據庫研究第一部分:區域性醫療中心的結直腸癌與人群特征. 中國普外基礎與臨床雜志, 2019, 26(2): 212-220.
4. 汪曉東, 呂沂, 黃明君, 等. 數據庫建設第二部分: 結直腸癌住院流程管理的標簽與結構化. 中國普外基礎與臨床雜志, 2019, 26(7): 852-855.
5. 劉健博, 呂炘沂, 鄒雨恒, 等. 多周期新輔助化療聯合阿帕替尼對進展期直腸癌的療效評價—基于DACCA數據庫的輔助研究. 中國普外基礎與臨床雜志, 2019, 26(6): 728-734.
6. 于瑞璇, 何欣林, 張秋露, 等. 華西DACCA的輔助研究: 單獨的新輔助化療不會影響直腸癌術后近期的肛門功能. 中國普外基礎與臨床雜志, 2019, 26(5): 595-601.
7. Isik O, Okkabaz N, Hammel J, et al. Preoperative functional health status may predict outcomes after elective colorectal surgery for malignancy. Surg Endosc, 2015, 29(5): 1051-1056.
8. Lin J, Peng J, Qdaisat A, et al. Severe weight loss during preoperative chemoradiotherapy compromises survival outcome for patients with locally advanced rectal cancer. J Cancer Res Clin Oncol, 2016, 142(12): 2551-2560.
9. Bagnall NM, Pring ET, Malietzis G, et al. Perioperative risk prediction in the era of enhanced recovery: a comparison of POSSUM, ACPGBI, and E-PASS scoring systems in major surgical procedures of the colorectal surgeon. Int J Colorectal Dis, 2018, 33(11): 1627-1634.
10. Baré M, Alcantara MJ, Gil MJ, et al. Validity of the CR-POSSUM model in surgery for colorectal cancer in Spain (CCR-CARESS study) and comparison with other models to predict operative mortality. BMC Health Serv Res, 2018, 18(1): 49.
11. Prabakaran V, Thangaraju T, Mathew AC, et al. CR-possum-can it be used to predict morbidity? A single-centre retrospective study. Indian J Surg Oncol, 2019, 10(1): 174-179.
12. Yan J, Wang YX, Li ZP. Predictive value of the POSSUM,p-POSSUM, cr-POSSUM, APACHE Ⅱ and ACPGBI scoring systems in colorectal cancer resection. J Int Med Res, 2011, 39(4): 1464-1473.
13. Ren L, Upadhyay AM, Wang L, et al. Mortality rate prediction by physiological and operative severity score for the enumeration of mortality and morbidity (POSSUM), portsmouth POSSUM and colorectal POSSUM and the development of new scoring systems in Chinese colorectal cancer patients. Am J Surg, 2009, 198(1): 31-38.
14. Tekkis PP, Poloniecki JD, Thompson MR, et al. Operative mortality in colorectal cancer: prospective national study. BMJ, 2003, 327(7425): 1196-1201.
15. 曹霖, 汪曉東, 陳珊珊, 等. ACPGBI結直腸癌術后風險評估模型臨床應用的初步探索. 中國普外基礎與臨床雜志, 2008, 15(9): 646-651, 655.
16. 汪曉東, 曹霖, 李立. 結直腸癌術后風險預測模型CCF-CCM的應用進展. 中國現代醫學雜志, 2012, 22(2): 91-94.
17. 汪曉東, 曹霖, 呂東昊, 等. 多學科協作診治模式下結直腸癌新輔助化療聯合手術的風險評估研究. 中國普外基礎與臨床雜志, 2008, 15(9): 692-696.
18. Stommel MW, de Wilt JH, ten Broek RP, et al. Prior abdominal surgery jeopardizes quality of resection in colorectal cancer. World J Surg, 2016, 40(5): 1246-1254.
19. Ishida H, Ishiguro T, Ishibashi K, et al. Impact of prior abdominal surgery on curative resection of colon cancer via minilaparotomy. Surg Today, 2011, 41(3): 369-376.
20. Ma RCW. Epidemiology of diabetes and diabetic complications in China. Diabetologia, 2018, 61(6): 1249-1260.
21. Li Y, Yang L, Wang L, et al. Burden of hypertension in China: a nationally representative survey of 174,621 adults. Int J Cardiol, 2017, 227: 516-523.
22. Cramer L, Hildebrandt B, Kung T, et al. Cardiovascular function and predictors of exercise capacity in patients with colorectal cancer. J Am Coll Cardiol, 2014, 64(13): 1310-1319.
23. Sagawa M, Yoshimatsu K, Yokomizo H, et al. Pulmonary dysfunction function and poor nutritional status are risk factors for remote infections following surgery for colorectal cancer. J Nippon Med Sch, 2018, 85(4): 208-214.
24. Wang Y, Zheng J, Gao Z, et al. Investigation on nutritional risk assessment and nutritional support status of surgical patients with colorectal cancer. J BUON, 2018, 23(1): 62-67.
25. Reischl S, Wilhelm DF, Neumann PA, et al. Peri- and postoperative nutrition in colorectal cancer patients. Ther Umsch, 2018, 75(10): 642-648.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Database research part Ⅲ: comorbidities and preoperative physical status of colorectal cancer

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