Thromboembolic risks after knee arthroplasty in patients with severe obesity: A large-scale analysis using Japanese medical claims data.

Background: Obesity is associated with an increased risk of complications after total knee arthroplasty (TKA) and unicompartmental knee arthroplasty (UKA), particularly in Western populations. However, the effect of severe obesity (body mass index [BMI] ≥ 35 kg/m) on postoperative complications in Japanese patients remains unclear.

Methods: We conducted a retrospective cohort study using Japan's Diagnosis Procedure Combination (DPC) database, including patients who underwent TKA or UKA between April 2016 and March 2023.

Impact of coronavirus disease 2019 on the clinical outcomes of acute pancreatitis: a nationwide observational study in Japan.

Background/objectives: Acute pancreatitis (AP) is a major gastrointestinal disorder with an increasing global incidence. However, the impact of coronavirus disease 2019 (COVID-19) on AP remains unclear, particularly in Japan. This study aimed to investigate the association between AP and COVID-19, including the influence of comorbidities, using a Japanese nationwide administrative database.

Effect of oral proton pump inhibitor administration on reducing the delayed bleeding risk in five upper gastrointestinal endoscopic treatments.

Objective: Although proton pump inhibitor (PPI) is often prescribed for reducing delayed bleeding in upper gastrointestinal endoscopic treatments, no studies with a sufficient sample size evaluated its reduced effect compared with absence of acid-suppressive agents. This study aimed to investigate the effect of oral PPI on reducing delayed bleeding in five upper gastrointestinal endoscopic treatments.

Methods: This population-based cohort study collected data from patients who were either prescribed with PPIs or received no acid-suppressive therapy and who underwent esophageal endoscopic mucosal resection (E-EMR), esophageal endoscopic submucosal dissection (E-ESD), gastric endoscopic mucosal resection (G-EMR), gastric endoscopic submucosal dissection (G-ESD), or percutaneous endoscopic gastrostomy (PEG) in Japan between 2012 and 2022 from the Diagnosis Procedure Combination database.

Impact of ongoing glucocorticoid use on postoperative complications following Total knee arthroplasty: a Japanese Nationwide propensity score-matched cohort study.

Background: Glucocorticoid use poses perioperative concerns in orthopaedic surgery, but its impact on postoperative outcomes following total knee arthroplasty (TKA) remains unclear.

Methods: This retrospective cohort study utilized the Japanese Diagnosis Procedure Combination (DPC) database to examine postoperative complications in patients undergoing TKA between April 2016 and March 2023. Patients receiving continuous glucocorticoid therapy (≥5 mg/day prednisolone equivalent) were identified and matched 1:1 with non-glucocorticoid users using propensity score matching based on age, sex, body mass index, anaesthesia type, simultaneous bilateral surgery, and Charlson Comorbidity Index.

Increased Risks of Surgical Site Infection and In-Hospital Mortality Following Knee Arthroplasty in Dialysis Patients: Insights From a Japanese Nationwide Cohort.

Background: Dialysis patients often develop advanced knee osteoarthritis, necessitating knee arthroplasty. Although total knee arthroplasty is commonly performed, limited data exist on perioperative complications among Japanese dialysis patients. This study uses a Japanese nationwide medical claims database to investigate the incidence of perioperative complications and mortality in dialysis versus nondialysis patients undergoing knee arthroplasty.

High risk of postoperative complications in dialysis patients undergoing total hip arthroplasty: a database study of Japanese nationwide medical claims.

Dialysis patients who develop degenerative hip disease or femoral neck fractures may require total hip arthroplasty, and their comorbidities predispose them to complications. This study aimed to evaluate whether dialysis was associated with early postoperative complications using a large database of Japanese. In this cohort study, using the Japanese National Administrative Diagnosis Procedure Combination database on THA for patients on hemodialysis or not from December 2011 to March 2023, we assessed the surgical-related complications, medical complications, and mortality during hospitalization after propensity score matching by age, sex, BMI, and comorbidities.

Postoperative risks of type 2 diabetes in elderly hip fracture patients: a propensity score-matched study.

Introduction: Type 2 diabetes is associated with an increased risk of fragility fractures, even in individuals with normal or high bone mineral density. However, the impact of type 2 diabetes on postoperative outcomes after hip fracture surgery in elderly Japanese patients remains unclear. This study evaluated the association between type 2 diabetes and postoperative complications, including in-hospital mortality, using a nationwide database in Japan.

Increased complications of proximal femur fractures during the COVID-19 pandemic: a nationwide medical claims database study in Japan.

Introduction: Coronavirus disease 2019 (COVID-19) is a worldwide pandemic, and mortality increases in elderly patients with comorbidities. This study aims to examine the in-hospital complications and mortality for elderly patients with proximal femur fractures during the COVID-19 pandemic or countermeasure periods.

Materials And Methods: The proximal femur fractures undergoing surgery during the COVID-19 pandemic or countermeasure period were compared with the pre-pandemic in a Japanese national inpatient data.

Increased risk of deep vein thrombosis and surgical site infection in cemented total knee arthroplasty: A nationwide propensity score-matched study in Japan.

Introduction: Total knee arthroplasty (TKA) is a widely used treatment for advanced knee osteoarthritis. While cemented fixation is the standard technique, cementless fixation has demonstrated comparable long-term outcomes. However, the association between cement use and postoperative complications, including venous thromboembolism and surgical site infections, remains unclear, particularly in Japanese patients.

Evolving Trends in Pediatric Inflammatory Bowel Disease Management in Japan: A Decade of Nationwide Data.

Aims: This study aimed to investigate the trends in pediatric inflammatory bowel diseases (IBD) management in Japan over the past decade.

Methods: We retrospectively analyzed data from Japan's nationwide database from 2012 to 2022. Patients aged ≤ 15 years diagnosed with Crohn's disease (CD) or ulcerative colitis (UC) were included.

Trends and outcomes of chemotherapy timing in critically ill patients with hematologic malignancies using a Japanese national database.

Hematologic malignancies are a global public health concern, with high mortality rates in patients requiring critical care. The role of chemotherapy during intensive care unit (ICU) admission in this context remains unclear. This study aimed to analyze trends in survival rates based on chemotherapy timing and examine patient characteristics, ICU treatments, and clinical outcomes in each group.

Thromboembolic and infectious complication risks in TKA and UKA: evidence from a Japanese nationwide cohort.

Introduction: Total knee arthroplasty (TKA) and unicompartmental knee arthroplasty (UKA) are widely used to treat knee osteoarthritis. TKA significantly contributes to long-term pain relief and joint function improvement, while UKA offers faster recovery and reduced early complications. However, TKA and UKA complication risks, aside from conditions such as deep vein thrombosis, have not been thoroughly investigated.

Current status and trends in ERCP and post-ERCP pancreatitis in Japan: a nationwide observational study.

Background: Endoscopic retrograde cholangiopancreatography (ERCP) is indispensable for the management of biliary and pancreatic diseases but carries a high risk of post-ERCP pancreatitis (PEP). This study aimed to clarify the current status and temporal trends of ERCP and PEP in Japan, including preventive measures.

Methods: We conducted a retrospective, population-based cohort study using the Diagnosis Procedure Combination database from April 1, 2016, to March 31, 2023.

Increased Periprosthetic Joint Infection Rate Following Total Knee Arthroplasty in Rheumatoid Arthritis Patients: Insights From a Japanese Nationwide Medical Claims Database Study.

Introduction: Advances in pharmacological treatments have reduced joint deformities in rheumatoid arthritis (RA), leading to a decline in total knee arthroplasty (TKA) among RA patients. However, RA remains associated with higher risks of postoperative complications. This study compares postoperative complications during hospitalization in patients with RA and osteoarthritis (OA) undergoing TKA in Japan.

Outcomes and cost-effectiveness of intermediate care units for patients discharged from the intensive care unit: a nationwide retrospective observational study.

Background: The clinical and economic impacts of intermediate care units (IMCUs) on intensive care unit (ICU)-discharged patients remain unclear due to inconsistent outcomes in previous studies. Under Japan's National Health Insurance Scheme, ICUs are categorized by staffing intensity (high or low). Using a nationwide inpatient database in Japan, we evaluated the clinical outcomes and cost-effectiveness of IMCUs for ICU-discharged patients.

Which of Vonoprazan Alone or Intravenous Proton Pump Inhibitor Followed by Vonoprazan Is Optimal for Reducing Delayed Bleeding in Gastric Endoscopic Submucosal Dissection?

Introduction: In gastric endoscopic submucosal dissection (ESD), both vonoprazan alone and intravenous proton pump inhibitor (PPI) followed by vonoprazan have lower delayed bleeding risk than PPI alone. This study aimed to clarify an optimal acid-suppressive method in gastric ESD.

Methods: This population-based cohort study included patients who underwent gastric ESD on only vonoprazan (vonoprazan alone group) or intravenous PPI followed by vonoprazan (intravenous PPI group) using the Diagnosis Procedure Combination database in Japan between 2014 and 2021.

Increased early complication rates following total hip arthroplasty in rheumatoid arthritis patients based on a Japanese nationwide medical claims database study.

Although the rate of total hip arthroplasty (THA) is declining among rheumatoid arthritis (RA) patients, the complex etiology of RA and associated immunomodulatory therapies may contribute to elevated risks of postoperative complications. This study aimed to evaluate in-hospital complications following THA in RA patients compared to osteoarthritis (OA) patients using a Japanese nationwide database. This retrospective study analyzed data from the Diagnosis Procedure Combination database, including THA patients between December 2011 and March 2023.

Regional Difference of Liver Cancer in Japan: A Real-world Evidence Using the National Database of Health Insurance Claims.

Objective The etiology of liver cancer is changing to metabolic dysfunction-associated steatotic liver disease, and ultrasound elastography is useful for identifying high-risk patients. However, these regional differences remain unclear. We aimed to investigate regional differences in the prevalence of liver cancer and the use of ultrasound elastography in Japan using the National Database of Health Insurance Claims (NDB).

Does Osteonecrosis of the Femoral Head Increase Early Complication Rates After Total Hip Arthroplasty? A Japanese Nationwide Medical Claims Database Study.

Background: Osteonecrosis of the femoral head (ONFH) and osteoarthritis (OA) are two common diagnoses for patients undergoing total hip arthroplasty (THA). The early surgical complications in THA for ONFH compared to OA are inconsistently reported. Therefore, this study aimed to evaluate whether THA for ONFH was associated with early postoperative complications in comparison to THA for OA using a large database of Japanese patients.

Exploring the impact of perioperative analgesia on postoperative chronic analgesic prescriptions in patients with lung cancer undergoing minimally invasive thoracic surgery: A retrospective observational study.

Background: Lung cancer surgery is associated with a high incidence of chronic postsurgical pain (CPSP), which necessitates long-term analgesic prescriptions. However, while essential for managing pain, these have shown various adverse effects. Current guidelines recommend using peripheral nerve blocks over epidural anaesthesia for perioperative analgesia in minimally invasive thoracic surgery (MITS).

Optimal direct oral anticoagulant for upper gastrointestinal endoscopic submucosal dissection.

Background: The patients taking direct oral anticoagulants (DOACs) are at high risk for developing ischemic stroke and delayed bleeding in upper gastrointestinal endoscopic submucosal dissection (ESD). We aimed to identify the optimal DOAC based on both adverse events in upper gastrointestinal ESD.

Methods: A retrospective population-based cohort study was conducted using the Diagnosis Procedure Combination database in Japan.

Clinical Practice and Safety of Endoscopic Balloon Dilation for Crohn's Disease-Related Strictures: A Nationwide Claim Database Analysis in Japan.

Although endoscopic balloon dilation (EBD) is a common therapeutic approach for managing strictures associated with Crohn's disease (CD), the clinical application and complication rates of EBD remain unclear. We collected admission data for patients who underwent EBD using a nationwide database. We compared EBD outcomes between ileal and colonic strictures, CD and ulcerative colitis, and CD and anastomotic strictures arising from cancer-related surgery.