Risk Management and Healthcare Policy (Mar 2021)
Effect of Time (Season, Surgical Starting Time, Waiting Time) on Patients with Gastric Cancer
Abstract
Dong Peng,* Ying-Ying Zou,* Yu-Xi Cheng, Wei Tao, Wei Zhang Department of Gastrointestinal Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, People’s Republic of China*These authors contributed equally to this workCorrespondence: Wei ZhangDepartment of Gastrointestinal Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, People’s Republic of ChinaTel +86-13808353353Email [email protected]: The purpose of the present study was to evaluate the effect of time (season, surgical starting time in the daytime, preoperative waiting time) on patients with gastric cancer.Methods: A retrospective collection of medical records of patients who underwent gastrectomy at a single clinical center from January 2013 to December 2018 was performed. Medical records were collected, and short-term outcomes and long-term survival were analyzed by different time groups.Results: A total of 586 patients were included in this study. In terms of surgical starting time, the midday group had a shorter operation time (p=0.017) but more complications (p=0.048) than the non-midday group. No significant difference was found based on the season of gastrectomy. The long preoperative waiting group had a shorter postoperative hospital stay than the short waiting group (p=0.026). No significant difference was found between the short-waiting group and long-waiting group in overall survival for all clinical stages. Age (p=0.040, HR=1.017, 95% CI=1.001– 1.033), BMI (p< 0.001, HR=0.879, 95% CI=0.844– 0.953) and clinical stage (p< 0.001, HR=2.053, 95% CI=1.619– 2.603) were independent prognostic factors predicting overall survival; however, season of gastrectomy, surgical starting time and preoperative waiting time were not identified as independent prognostic factors.Conclusion: Surgical starting time at the midday could cause more complications, and surgeons should be careful when the surgical starting time is midday.Keywords: gastric cancer, season, waiting time, surgical starting time
