ObjectiveTo analyze the geographical distribution of patients with colorectal cancer by screening the current Database from Colorectal Cancer (DACCA) version in West China Hospital.MethodsThe selected DACCA database version of this data analysis was updated on September 5, 2019, and the two data of the " date of operation” and " address” were selected as the main research items. The characteristics of each selected data item were analyzed, and then the selected data were used as a joint feature analysis.ResultsAccording to the condition of selection by " address”, 7 096 valid data rows from the whole nation were obtained, 6 551 valid data rows from Sichuan province were obtained, and 2 954 valid data rows from Chengdu city were obtained. The geographic information provided by the DACCA database showed that, with the year changing, the provincial distribution area of patients was mainly the southwest region with middle-east of Sichuan province as center, mainly including the parts of Chongqing, Yunnan, and Guizhou; The distribution area of the municipal level in Sichuan province was mainly the east region with axis of the " Mianyang-Chengdu-Ya’an”, and Chengdu was the core; The regional distribution of patients in the Chengdu was mainly within the third ring load with Wuhou District, the Jinniu District, and the Qingyang District as the core area.ConclusionThegeographical information provided by DACCA database shows the geographical distribution characteristics of patients in the past 20 years, reflecting the basic characteristics and changes of the service area of West China Hospital, and can provide a basis for medical policy makers in screening, diagnosing and treating of colorectal cancer, and key management areas of following-up.
ObjectiveTo describe the constructive process of follow-up of colorectal cancer part in the Database from Colorectal Cancer (DACCA) in West China Hospital. MethodThe article was described in words. ResultsThe specific concepts of follow-up of colorectal cancer including end-stage of follow-up, survival status, follow-up strategy, follow-up emphasis, follow-up plan, follow-up record using communication tools, follow-up frequency, annual follow-up times, and single follow-up record of the DACCA in the West China Hospital were defined. Then they were detailed for their definition, label, structure, error correction, and update. ConclusionThrough the detailed description of the details of follow-up of colorectal cancer of DACCA in West China Hospital, it provides the standard and basis for the clinical application of DACCA in the future, and provides reference for other peers who wish to build a colorectal cancer database.
ObjectiveBased on the current version of Database from Colorectal Cancer (DACCA), we aimed to analyze the comorbidities and preoperative physical status of colorectal cancer patients.MethodsThe 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.ResultsA 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: ŷ=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: ŷ=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%).ConclusionsThrough 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.
ObjectiveTo analyze the tumor characteristics of colorectal cancer in the current version of Database from Colorectal Cancer (DACCA).MethodsThe DACCA version was the updated version on April 16, 2020. The data items including: procedure of anastomosis, shape of anastomosis, enhanced suture for anastomosis, stuffing, drainage, coverage of major omentum, anti-adhesion material, reconstruction of pelvic peritoneum, contaminate, and drug implants were analyzed for the characteristics of each selected data item.ResultsA total of 6 338 analyzable data rows were obtained by screening the DACCA database. Among the 6 338 pieces of data, the most common one was the double staple technique (58.1%), end-to-end anastomosis (69.4%), one-total-circle of enhancement (33.2%), and without stuffing (54.1%) in the items of procedure of anastomosis, shape of anastomosis, enhanced suture for anastomosis, stuffing, respectively; the ratio with drainage was higher (79.2%) in the term of drainage, the drainage time was (3.74±2.89) d and median drainage time was 3.00 d; the ratio with covering part of major omentum, without anti-adhesion material, with unilateral partial closure, without contaminate, and without drug implants were more higher, which was 41.1%, 79.8%, 58.7%, 73.9%, and 53.9% in the items of coverage of major omentum, anti-adhesion material, reconstruction of pelvic peritoneum, contaminate, and drug implants, respectively.ConclusionIt might better explain the outcome of surgery associated with intraoperative operation by studying the features of surgery of DACCA and guide the operation in the future for better outcomes.
ObjectiveTo explain surgery reaction and perioperative complications of colorectal cancer in detail as well as their tags and structures of Database from Colorectal Cancer (DACCA) in the West China Hospital.MethodThe article was described in words.ResultsThe surgery reaction and perioperative complications of colorectal cancer module including temperature, flatus, pain, and mental status, as well as preoperative complications, intraoperative complications, postoperative complications (short-term complications and long-term complications) of the DACCA in the West China Hospital were defined. The data label corresponding to each item in the database and the structured way needed for the big data application stage in detail were explained. And the error correction notes for all classification items were described.ConclusionsThrough the detailed description of the surgery reaction and perioperative complications of colorectal cancer of DACCA in West China Hospital, it provides standard and basis for clinical application of DACCA in future, and provides reference for other peers who wish to build a colorectal cancer database.
ObjectiveTo analyze the characteristics of colorectal cancer surgery in the current version of Database from Colorectal Cancer (DACCA).MethodsThe DACCA version selected for this data analysis was the updated version on April 16th, 2020. The data items included timing of operation, types of operative procedure, radical resection level of operation, patient’s wish of anus-reserving, types of stomy, date of stoma closure, surgical approaches, extended resection, and type of intersphincteric resection (ISR). The data item interval of stoma closure was added, and the selected data items were statistically analyzed.ResultsThe total number of medical records (data rows) that met the criteria was 11 757, including 2 729 valid data on the timing of operation (23.2%), 11 389 valid data on the types of operative procedure (96.9%), 4 255 valid data on the radical resection level of operation (36.2%), 3 803 valid data on patient’s wish of anus-reserving (32.3%), 4 377 valid data on types of stomy (37.2%), 989 valid data on date of stoma closure (8.4%), 4 418 valid data on surgical approaches (37.6%), 3 941 valid data on extended resection (33.5%), and 1 156 valid data on type of ISR (9.8%). In the timing of operation, the most cases were performed immediately after discovery or neoadjuvant completion (915, 33.5%). In types of operative procedure, ultra low anterior resection (ULAR), right hemicolectomy (RHC), and low anterior resection (LAR) were the most, including 1 986 (17.4%), 1 412 (12.4%), and 1 041 (9.1%) lines. Respectively in the colon and rectal cancer surgery, the proportion of RHC (50.0%) and ULAR (26.0%) was the highest, with 172 (26.1%) and 815 (27.9%) extended resection. In ISR surgery the majority was ISR-2 (741, 64.1%). In radical resection level of operation, the number of R0 was the largest with 2 575 (60.5%) lines. In patient’s wish of anus-reserving, positive and rational were the most with 1 811 (47.6%) and 1 440 (37.9%) lines, respectively. And in types of stomy, there were 2 628 lines (60.0%) without stoma and 1 749 cases (40.0%) with stoma, among which the most lines were right lower ileum stoma (612, 35.0%). The minimum value, maximum value, and median value of interval of stoma closure were 0 d, 2 678 d and 112 d. The linear regression prediction of date of stoma closure by year was \begin{document}${\hat {y}} $\end{document}=9.234 3x+22.394 (R2=0.2928, P=0.07). In the surgical approaches, the majority was standard with 3 182 (72.0%) lines.ConclusionsIn the DACCA, rectal cancer surgery is still the majority, and ULAR is the most type. The application of extended resection in both colon and rectal cancer has important significance. The data related to stoma are diversified and need to be further studied.
ObjectiveTo analyze the staging methods of colorectal cancer data in the current version of the Database from Colorectal Cancer (DACCA).MethodsThe DACCA version selected for this data analysis was updated at April 16th, 2020. The columns included stage during surgery, comprehensive stage of clinical, pathologic and imaging (cpi comprehensive stage), TNM stage, pathologic T stage, imaging T stage, nerves involvement, pathologic anus stage, clinical anus stage, imaging anus stage, pathologic mesentery stage, clinical mesentery stage, imaging mesentery stage, pathologic N stage, imaging N stage, positive lymph nodes ratio, cancerous nodules, M stage, cancerous emboli, pathologic vessel stage, clinical vessel stage, imaging vessel stage, cancerous contamination, and high-risk factors. Extracted data were statistically analyzed.ResultsThe total number of data medical records (data rows) that met the criteria was 6 474, the valid data of TNM stage was 4 511 (69.7%), the valid data of stage during surgery was 5 684 (87.8%), and the valid data of cpi comprehensive stage was 4 045 (62.5%). 1 540 data (41.6%) were consistent with stage during surgery and TNM stage, and 2 884 data (76.7%) were consistent with cpi comprehensive stage and TNM stage. According to the data of T, N, and M stage, the proportion of patients with pathologic T4a stage was the highest (40.5%), followed by T3 stage (24.8%); the most T4a stage (31.9%) on the image, followed by T4b stage (28.7%). The pathologic N stage with lymph node metastasis was about 41.9% (N1 and N2), and the imaging N stage lymph node metastasis was about 51.4%. There were a total of 4 745 valid data in the M stage (73.3%). There were 4 313 valid data in the nerves involvement (66.7%), suspected involvement and confirmed involvement, were 691 (16.0%) and 253 (5.9%) respectively. The valid data of anal pathology, clinical, and imaging stage were 4 115 (63.6%), 599 (9.3%), and 598 (9.2%), and only 30 (0.7%), 8 (1.3%), and 13 (2.2%) on muscle involvement respectively. The valid data of pathologic, clinical, and imaging mesentery stage were 732 (11.3%), 589 (9.1%), and 592 (9.1%). There were 4 458 (68.9%) valid data of positive lymph nodes ratio, and 2 908 (44.9%) valid data of cancerous nodules. There were 4 286 valid data of cancerous emboli (66.2%). A total of 244 data (41.1%) of increased blood vessels around tumors in the imaging vessel stage, 274 data (46.4%) of that in clinical vessel stage, and only 1 063 (27.7%) of pathologic vessel stage. There were 3 865 valid data (59.7%) of the cancerous contamination, and the proportion of the third level (746/2 753, 27.1%) in the high-risk factors was the highest.ConclusionThrough detailed analysis of the DACCA database, it is hoped that a more complete and accurate evaluation system of tumor severity can be established, and high-risk factors can provide some ideas for judging prognosis.
In recent years, day surgery has developed rapidly in China. Day surgery management has shifted from extensive to refined, but there are still many problems in the service system of day surgery in Chinese hospitals. In order to further optimize the allocation of medical resources, improve the level of medical service capacity, and build a “patient-centered, safe, efficient, and orderly” day surgery service system, Northern Jiangsu People’s Hospital has integrated big data, mobile internet, and artificial intelligence since 2019, creating a smart information big data platform. This paper summarizes the experience of Northern Jiangsu People’s Hospital in promoting the high-quality development of day surgery services in the whole hospital from five aspects of top-level design, diagnostic and therapeutic process, medical quality and safety, medical supporting services, and supervision mechanism, with a view to providing reference for the implementation of overall management of day surgery in the hospital.
ObjectiveTo analyze the tumor characteristics of colorectal cancer in the current version of Database from Colorectal Cancer (DACCA).MethodsThe DACCA version was the updated version on September 26, 2019. The data items included: date of surgery, precancerous lesions, cancer family, tumor site, distance to the dentate line, morphology of tumor, size, position, happening and origination, differentiation, pathology of tumor, Ki-67 of protein, complications (included obstruction, intussusception, perforation, pain, edema, and hemorrhage) were analyzed for the characteristics of each selected data item.ResultsA total of 11 898 analyzable data rows were obtained by screening the DACCA database. Among the 11 898 pieces of data, the effective data of precancerous lesions was 1 275, including 541 (42.4%) with precancerous lesions, and 734 (57.6%) without precancerous lesions. There were 1 116 valid data on cancer families, and 761 (6.4%) had a family history of cancer. The Ki-67 index had a total of 1 893 valid data, which ranged form 0 to 95% [(59.0±20.1) %]. According to the classification of tumor occurrence, the primary colorectal cancer accounted for the vast majority (92.8%), and the metastatic colorectal cancer was the least (0.3%). According to the primary and multiple primary, respectively analysis of tumor site, distance to the dentate line, morphology of tumor, size, position, differentiation, and pathology of tumor showed that, most tumor’s position were in the rectum (76.9%, 41.9%), the most common morphology was ulcers (42.4%, 51.5%), the most tumors were located around the wall of intestine (44.6%, 35.0%), the degree of differentiation was mostly moderate (65.4%, 61.3%), most of the tumor pathologies were adenocarcinoma (77.8%, 64.0%).ConclusionA more accurate and detailed analysis of colorectal cancer tumor characteristics by the DACCA database is helpful for determining the diagnosis and treatment plan in clinical work, judging the prognosis, and so on.