title: Dramatic decreases in mortality from laparoscopic colon resections based on data from the Nationwide Inpatient Sample.
abstract: OBJECTIVE
  To determine the mortality rate and associated factors for laparoscopic and open colectomy as derived from the Nationwide Inpatient Sample database.
  
  
  METHODS
  Retrospective cohort.
  
  
  METHODS
  Nationwide Inpatient Sample database.
  
  
  METHODS
  Between 2002 and 2007, the Nationwide Inpatient Sample estimated 1,314,696 patients underwent colectomy in the United States. Most (n = 1,231,184) were open, but 83,512 were laparoscopic. Patients who underwent a laparoscopic procedure that was converted to open were analyzed within the laparoscopic group on an intention-to-treat basis.
  
  
  METHODS
  Mortality rate. Using a logistic regression model, patient and institutional characteristics were analyzed and evaluated for significant associations with in-hospital mortality.
  
  
  RESULTS
  In a multivariate analysis, significant predictors of increased mortality included older age, male sex, lower socioeconomic status, comorbidities, and emergency or transfer admission. Additionally, a laparoscopic approach was an independent predictor of decreased mortality when compared with open colectomy (relative risk, 0.51; P < .001).
  
  
  CONCLUSIONS
  Even when controlling for comorbidities, socioeconomic status, practice setting, and admission type, laparoscopy is an independent predictor of decreased mortality for colon resection.
authors.affiliation: Department of Surgery, Oregon Health and Science University, 3181 SW Sam Jackson Park Rd, Portland, OR 97239, USA.
authors.forename: Molly M
authors.initials: MM
authors.lastname: Cone
authors.forename: Daniel O
authors.initials: DO
authors.lastname: Herzig
authors.forename: Brian S
authors.initials: BS
authors.lastname: Diggs
authors.forename: James P
authors.initials: JP
authors.lastname: Dolan
authors.forename: Jennifer D
authors.initials: JD
authors.lastname: Rea
authors.forename: Karen E
authors.initials: KE
authors.lastname: Deveney
authors.forename: Kim C
authors.initials: KC
authors.lastname: Lu
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D003082:Colectomy / Q000401:mortality*; D003108:Colonic Diseases / Q000401:mortality* / Q000601:surgery*; D003110:Colonic Neoplasms / Q000401:mortality* / Q000601:surgery*; D015897:Comorbidity; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007223:Infant; D010535:Laparoscopy / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012044:Regression Analysis; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate; D014481:United States; D055815:Young Adult