Preoperative oral care by a dentist significantly reduced postoperative complications in patients who underwent cancer surgery.

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A BSTRA CT BACKGROUND Electronic health databases are increasingly used for research purposes. The Japanese National Database of Health Insurance Claims and Specific Health Checkups (NDB) is a large national administrative claims database. We reviewed published original articles that used the NDB. METHODS Studies published from January 2011 to June 2019 using the NDB were identified through PubMed and the academic product lists of the NDB, following the PRISMA guidelines. RESULTS 68 studies were included in our review (43 were in English and 25 were in Japanese). The first NDB study in English was published in 2015, which was 4 years after the NDB was released for research purposes. The average annual growth rate of the number of NDB studies in English was 237% after the first publication of an NDB study in English. Descriptive studies were the most common study design (n = 42), and the Clinical Medicine was the most common research area (n = 18). The study strength most frequently mentioned by authors of the NDB studies was the large sample size. In terms of limitations, authors most frequently mentioned the lack of important data and validation studies. CONCLUSIONS Since its release, the NDB has increasingly attracted attention, and the number of studies using the NDB has grown rapidly. The large sample size and wide array of health care data in the NDB enabled researchers to conduct health service research in various research areas with several study designs. Finally, our review suggests to policy makers that administrative database should be constructed and managed with the environment which promote researchers access to the database and link it to other databases. Although the protection of respondents' privacy should be carefully considered, higher accessibility and data linkage may maximize the potential of the administrative database and may enable researchers to produce more valuable health service researches for policy making in health care.

Only 19% of residents were discharged to home. Our results are useful for policy-makers to promote discharge to home of older adults in geriatric intermediate care facilities.

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Background COVID-19 has worse mortality than influenza in American and European studies, but evidence from the Western Pacific region is scarce. Methods Using a large-scale multicenter inpatient claims data in Japan, we identified individuals hospitalised with COVID-19 in 2020 or influenza in 2017–2020. We compared patient characteristics, supportive care, and in-hospital mortality, with multivariable logistic regression analyses for in-hospital mortality overall, by age group, and among patients with mechanical ventilation. Findings We identified 16,790 COVID-19 patients and 27,870 influenza patients, with the different age distribution (peak at 70–89 years in COVID-19 vs. bimodal peaks at 0–9 and 80–89 years in influenza). On admission, the use of mechanical ventilation was similar in both groups (1·4% vs. 1·4%) but higher in the COVID-19 group (3·3% vs. 2·5%; p<0·0001) during the entire hospitalisation. The crude in-hospital mortality was 5·1% (856/16,790) for COVID-19 and 2·8% (791/27,870) for influenza. Adjusted for potential confounders, the in-hospital mortality was higher for COVID-19 than for influenza (adjusted odds ratio [aOR] 1·83, 95% confidence interval [CI] 1·64–2·04). In age-stratified analyses, the aOR (95%CI) were 0·78 (0·56–1·08) and 2·05 (1·83–2·30) in patients aged 20–69 years and ≥70 years, respectively (p-for-interaction<0·0001). Among patients with mechanical ventilation, the aOR was 0·79 (0·59–1·05). Interpretation Patients hospitalised with COVID-19 in Japan were more likely to die than those with influenza. However, this was mainly driven by findings in older people, and there was no difference once mechanical ventilation was started. Funding Ministry of Health, Labour and Welfare of Japan (21AA2007).

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OBJECTIVEAlthough sinusitis-induced intracranial complications rarely occur in the current era of antibiotics, they can induce neurological symptoms or death. The authors of this study investigated the association between endoscopic sinus surgery (ESS) and outcomes in patients who had undergone neurosurgical procedures for sinusitis-induced intracranial abscess.METHODSThe authors obtained data on patients with sinusitis-induced intracranial abscess from the Japanese Diagnosis Procedure Combination inpatient data for the period from 2010 to 2017. They excluded patients with fungal sinusitis, orbital complications, immunodeficiency, and malignant disease. They also excluded patients who had received antifungal agents, chemotherapy, immunosuppressants, and antidiabetic drugs. Eligible patients were divided into those with and those without neurosurgical procedures. Propensity score–adjusted regression analyses were performed to examine the association between ESS within the same hospitalization and outcomes (mortality, blood transfusion, readmission, revision neurosurgery, and length of stay).RESULTSOf the 552 potentially eligible patients, 255 were treated with neurosurgical procedures, including 104 who underwent ESS within the same hospitalization and 151 who did not. ESS was not significantly associated with mortality (OR 0.54, 95% CI 0.05–5.81, p = 0.61), blood transfusion (OR 1.95, 95% CI 0.84–4.51, p = 0.12), readmission (OR 0.86, 95% CI 0.34–2.16, p = 0.75), revision neurosurgery (OR 0.65, 95% CI 0.24–1.74, p = 0.39), or length of stay (percent difference −10.8%, 95% CI −24.4% to 5.1%, p = 0.18).CONCLUSIONSThe present study suggests that ESS may not have significant benefits with respect to reducing mortality, blood transfusion, readmission, revision neurosurgery, or length of stay.