Previous Use of Mammography as a Proxy for General Health Checks in Association with Better Outcomes after Major Surgeries

Abstract

Although previous studies have shown that health checks may improve several risk factors for chronic diseases, the effect of preoperative health checks on postoperative recovery in surgical patients remains unknown. We aimed to investigate the association between preoperative use of mammography and the risk of perioperative complications. We conducted a matched cohort study of 152,411 patients aged ≥47 years who received mammography screening and later underwent major surgery from 2008 to 2013. Using a propensity score matching procedure adjusted for sociodemographic characteristics, medical condition, surgery type, and anesthesia type, 152,411 controls who underwent surgery but were not screened were selected. We collected patients’ characteristics and medical conditions from claims data of Taiwan’s National Health Insurance. Logistic regressions were used to calculate odds ratios (ORs) with 95% confidence intervals (CIs) for postoperative complications and in-hospital mortality associated with mammography screening. Patients receiving mammography prior to major surgery had significantly lower risks of perioperative complications, including pneumonia, septicemia, acute renal failure, stroke, urinary tract infection, deep wound infection, acute myocardial infarction, intensive care unit stay, and 30 day in-hospital mortality (OR 0.45, 95% CI 0.38–0.53). The association was consistent across each stratum of age, number of hospitalizations, emergency visits, and comorbidities. In conclusion, preoperative use of mammography was strongly associated with fewer perioperative complications and less in-hospital mortality after major surgeries. The evidence provided by this study justifies the implementation of preoperative health checks in clinical practice.

Preexisting Dementia Is Associated with Increased Risks of Mortality and Morbidity Following Major Surgery: A Nationwide Propensity Score Matching Study

“…The Taiwan National Health Insurance program was established in March 1995 and covered more than 99% of 23.4 million Taiwanese residents at the end of 2013. The National Health Insurance (NHI) research database contains comprehensive data of the insured individuals, including demographic characteristics (date of birth, sex, and residential location) and claims data (outpatient and inpatient care, physicians’ primary and secondary diagnoses, prescriptions, treatment procedures, and medical expenditures) [ 12 , 13 , 14 , 15 , 16 , 17 ].…”