Database research part <b>Ⅱ</b>: in-hospital process management of colorectal cancer_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

WANG Xiaodong ¹ , AN Limin 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 in Sichuan University, Chengdu 610041, P. R. China;

Corresponding?author：

LI Li, Email: drlilli116@126.com

Keywords：

colorectal cancer; database; bigdata; medical process; enhanced recovery after surgery

DOI：

10.7507/1007-9424.201902009

Video：

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Objective Based on recently update Database from Colorectal Cancer (DACCA), we aimed to analyze the characteristics of in-hospital process management from reginal medical center’s colorectal cancer patients.Methods We used Version January 29^th, 2019 of DACAA being the analyzing source. The items were included date of first out-patient meeting, admitted date, operative date, discharged date, waiting-time, preoperative staying days, postoperative staying days, hospital staying days, and manage protocol, whose characteristics would be analyzed.Results We left 8 913 lines to be analyzed by filtering DACCA. Useful data lines of first out-patient meeting had 3 915, admitted date had 8 144, operative date had 8 049, and discharged date had 7 958. The average of waiting-time were (9.41±0.43) days, and based on timeline trend for line prediction analyzing, which showed R²=0.101 257, P<0.001. The average of preoperative staying days were (5.41±0.04) days, and based on timeline trend for line prediction analyzing, which showed R²=0.023 671, P<0.001. The average of postoperative staying days were (8.99±0.07) days, and based on timeline trend for line prediction analyzing, which showed R²=0.086 177, P<0.001. The average of hospital staying days were (14.43±0.08) days, and based one timeline trend of line prediction analyzing, which showed R²=0.098 44, P<0.001. Analyzable ERAS data were 2 368 lines in DACCA. Total EARS data in 2 368 lines, there were 108 lines (5%) completed and 2 260 lines (95%) incomplete. Pre/post ERAS data in 2 260 lines, there were 150 lines (7%) completed and 2 110 lines (93%) incomplete. Post ERAS data in 2 110 lines, there were 170 lines (8%) completed and 1 940 lines (92%) incomplete.Conclusions In recent 20 years, the regional medical center served in-hospital colorectal cancer patients with decreased preoperative staying days, postoperative staying days, and in-hospital staying days from DACCA analyzing, which could prove the service ability had been in improved. Utilization rate of EARS was increased, and also being the main in-hospital process management.

Citation： WANG Xiaodong, AN Limin, LI Li. Database research part Ⅱ: in-hospital process management of colorectal cancer. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2019, 26(4): 469-475. doi: 10.7507/1007-9424.201902009 Copy

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2.	呂東昊, 汪曉東, 陽川華, 等. 結直腸腫瘤多學科協作診治模式的數據庫初期建設現狀. 中國普外基礎與臨床雜志, 2007, 14(6): 713-715.
3.	汪曉東, 李立. 真實場景與大數據下的整體微創理念, 大幅提高結直腸癌遠期生存率. 中國普外基礎與臨床雜志, 2019, 26(1): 92-95.
4.	汪曉東, 李希, 何欣林, 等. 數據庫研究第一部分: 區域性中心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.
5.	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.
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18.	劉展, 汪曉東, 李立. 結直腸外科快速流程內容及依據. 中國普外基礎與臨床雜志, 2007, 14(4): 469-473.
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21.	李卡, 胡艷杰, 劉雨薇, 等. 加速康復外科應用于結直腸癌根治術圍手術期管理的效果研究. 中華結直腸疾病電子雜志, 2018, 7(3): 288-293.
22.	胡艷杰, 李卡, 李立, 等. 術前機械性腸道準備對結腸癌患者早期康復療效的影響: 隨機對照試驗. 南方醫科大學學報, 2017, 37(1): 13-17.
23.	國務院辦公廳. 國務院辦公廳關于推進分級診療制度建設的指導意見(國辦發[2015] 70號). 2015-09-11. http://www.gov.cn/zhengce/content/2015-09/11/content_10158.htm.
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25.	Li H, Liu K, Gu J, et al. The development and impact of primary health care in China from 1949 to 2015: a focused review. Int J Health Plann Manage, 2017, 32(3): 339-350.

1. 汪曉東, 李立. 結直腸腫瘤多學科協作診治模式的數據體系構建與運作策略. 中國普外基礎與臨床雜志, 2007, 14(4): 474-476.
2. 呂東昊, 汪曉東, 陽川華, 等. 結直腸腫瘤多學科協作診治模式的數據庫初期建設現狀. 中國普外基礎與臨床雜志, 2007, 14(6): 713-715.
3. 汪曉東, 李立. 真實場景與大數據下的整體微創理念, 大幅提高結直腸癌遠期生存率. 中國普外基礎與臨床雜志, 2019, 26(1): 92-95.
4. 汪曉東, 李希, 何欣林, 等. 數據庫研究第一部分: 區域性中心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.
5. 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.
6. 李立, 汪曉東, 舒曄, 等. 四川大學華西醫院肛腸外科·結直腸外科快速流程臨床指南(一). 中國普外基礎與臨床雜志, 2009, 16(5): 413.
7. Kehlet H, Wilmore DW. Evidence-based surgical care and the evolution of fast-track surgery. Ann Surg, 2008, 248(2): 189-198.
8. 李立, 汪曉東, 舒曄, 等. 四川大學華西醫院肛腸外科·結直腸外科快速流程臨床指南(二). 中國普外基礎與臨床雜志, 2009, 16(6): 493-494.
9. 李立, 汪曉東, 舒曄, 等. 四川大學華西醫院肛腸外科·結直腸外科快速流程臨床指南(三). 中國普外基礎與臨床雜志, 2009, 16(7): 581.
10. 李立, 汪曉東, 舒曄, 等. 四川大學華西醫院肛腸外科·結直腸外科快速流程臨床指南(四). 中國普外基礎與臨床雜志, 2009, 16(8): 671.
11. ERAS Society. HISTORY. 2016-12-31. http://erassociety.org/about/history/.
12. 蔣朱明. 住院患者腸外營養支持的適應證臨床指南(2005年12月版). 中華外科雜志, 2006, 44(23): 1596-1598.
13. 四川省人民政府. 2017年四川省國民經濟和社會發展統計公報. 2018-02-28. http://www.sc.gov.cn/10462/10464/10797/2018/2/28/10445753.shtml.
14. 成都市統計局. 2017年成都市國民經濟和社會發展統計公報. 2018-05-15. http://www.cdstats.chengdu.gov.cn/htm/detail_96522.html.
15. Chen W, Sun K, Zheng R, et al. Cancer incidence and mortality in China, 2014. Chin J Cancer Res, 2018, 30(1): 1-12.
16. Banerjea A, Voll J, Chowdhury A, et al. Straight-to-test colonoscopy for 2-week-wait referrals improves time to diagnosis of colorectal cancer and is feasible in a high-volume unit. Colorectal Dis, 2017, 19(9): 819-826.
17. 劉展, 汪曉東, 李立. 多學科協作診治模式下的結直腸外科快速康復流程. 中國普外基礎與臨床雜志, 2007, 14(2): 239-242.
18. 劉展, 汪曉東, 李立. 結直腸外科快速流程內容及依據. 中國普外基礎與臨床雜志, 2007, 14(4): 469-473.
19. 劉春娟, 李卡, 汪曉東. 快速流程在結直腸外科圍術期護理中的臨床應用進展. 護理研究, 2008, 22(33): 3011-3012.
20. 劉展, 楊廷翰, 余曦, 等. 快速流程圍手術期臨床管理降低結直腸癌手術炎性反應的隨機臨床研究. 中國普外基礎與臨床雜志, 2010, 17(8): 855-859, 864.
21. 李卡, 胡艷杰, 劉雨薇, 等. 加速康復外科應用于結直腸癌根治術圍手術期管理的效果研究. 中華結直腸疾病電子雜志, 2018, 7(3): 288-293.
22. 胡艷杰, 李卡, 李立, 等. 術前機械性腸道準備對結腸癌患者早期康復療效的影響: 隨機對照試驗. 南方醫科大學學報, 2017, 37(1): 13-17.
23. 國務院辦公廳. 國務院辦公廳關于推進分級診療制度建設的指導意見(國辦發[2015] 70號). 2015-09-11. http://www.gov.cn/zhengce/content/2015-09/11/content_10158.htm.
24. Li X, Lu J, Hu S, et al. The primary health-care system in China. Lancet, 2017, 390(10112): 2584-2594.
25. Li H, Liu K, Gu J, et al. The development and impact of primary health care in China from 1949 to 2015: a focused review. Int J Health Plann Manage, 2017, 32(3): 339-350.

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Database research part Ⅱ: in-hospital process management of colorectal cancer

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