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A retrospective observational study used nationwide health services utilisation data from 1 Jan 2015 to 31 Dec 2016 across 431 hospitals. Patients receiving ESD/EMR or laparoscopic/open surgery were followed for ADL decline at discharge, death, and unexpected readmission within 6 weeks, with outcomes stratified by age (40–74, 75–79, ≥80).",{"@graph":69,"@context":123},[70,84,106],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/activities-of-daily-living-after-surgery-among-older-patients-with-gastrointestinal-and-hepatobiliary-pancreatic-cancers-a-retrospective-observational-study-using-nationwide-health-services-utilisation-data-from-japan/377906/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/activities-of-daily-living-after-surgery-among-older-patients-with-gastrointestinal-and-hepatobiliary-pancreatic-cancers-a-retrospective-observational-study-using-nationwide-health-services-utilisation-data-from-japan/377906.png","ImageObject",300,407,{"name":92,"@type":93},"Aurelia","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-11-03","2026-09-24",true,{"@type":102,"interactionType":103,"userInteractionCount":105},"InteractionCounter",{"@type":104},"ViewAction",14,{"@type":107,"mainEntity":108},"FAQPage",[109,115,119],{"name":110,"@type":111,"acceptedAnswer":112},"What was the study’s main objective regarding ADLs after surgery?","Question",{"text":113,"@type":114},"To evaluate activities of daily living after oncological surgery in patients with gastrointestinal and hepatobiliary-pancreatic cancers, stratified by age group, using Japan nationwide data.","Answer",{"name":116,"@type":111,"acceptedAnswer":117},"Which treatments and patient groups were included in the analysis?",{"text":118,"@type":114},"Patients who underwent endoscopic submucosal dissection (ESD), endoscopic mucosal resection (EMR), and laparoscopic or open surgery were included, with outcomes compared across age groups (40–74, 75–79, and ≥80 years).",{"name":120,"@type":111,"acceptedAnswer":121},"How were outcomes measured after surgery?",{"text":122,"@type":114},"Outcomes included the proportion of ADL decline at discharge, death, and unexpected readmission within 6 weeks postsurgery, calculated by age group.","https://schema.org",{"og:url":83,"og:type":125,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":127,"canonical":83},"index,follow",{"doc_id":129,"site_id":62},377906,1790456183,{"code":4,"msg":5,"data":132},{"doc_id":129,"user_id":133,"nickname":92,"user_avatar":134,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":105,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":29,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":145},1099514068365,"https://ap-avatar.wpscdn.com/avatar/10000253d8d9f28188e?_k=1776742907772140068","Open access Original research  \n Activities of daily living after surgery  \namong older patients with gastrointestinal and hepatobiliarypancreatic cancers: a retrospective observational study using nationwide health services utilisation data  \nfrom Japan  \nAyako Okuyama  ,1,2 Hisashi Kosaka,3 Masaki Kaibori,3 Takahiro Higashi,2 Asao Ogawa4  \nTo cite: Okuyama A, Kosaka H, Kaibori M, et al. Activities of daily living after surgery among older patients  \nwith gastrointestinal and hepatobiliary-pancreatic cancers: a retrospective observational study  \nusing nationwide health services utilisation data  \nfrom Japan. BMJ Open 2023;13:e070415 . doi:10 . 1136/ bmjopen-2022-070415  \n► Prepublication history and additional supplemental material for this paper are available online. To view these files, please visit the journal online ([http://dx.doi.org/10.1136/](http://dx.doi.org/10.1136/)[ ](http://dx.doi.org/10.1136/)[bmjopen-2022-070415](bmjopen-2022-070415)) .  \nReceived 28 November 2022 Accepted 12 May 2023  \n© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.  \nFor numbered affiliations see end of article.  \nCorrespondence to  \nDrAyako Okuyama;  \n[okuyama.ayako.r3@slcn.ac.jp](okuyama.ayako.r3@slcn.ac.jp)  \nABSTRACT  \nObjectives The effectiveness and impact of any treatment on patients’ physical functions, especially in older patients, should be closely considered. This study aimed to evaluate activities of daily living (ADLs) after oncological surgery inpatients with gastrointestinal and hepatobiliary-pancreatic cancers by age groups in Japan.  \nDesign Retrospective observational study using health services utilisation data from 1 January 2015 to 31 December 2016.  \nSetting Data for patients with gastrointestinal and hepatobiliary-pancreatic cancers diagnosed in 2015 from 431 hospitals nationwide in Japan.  \nParticipants Patients who underwent endoscopic submucosal dissection (ESD), endoscopic mucosal resection (EMR) and laparoscopic or open surgery were included.  \nOutcome measures The proportion of ADL decline at discharge, death and unexpected readmission within 6 weeks postsurgery was calculated by age groups (40–74, 75–79 and ≥80 years) .  \nResults Data for 68 032 patients were analysed. The difference in the proportion of ADL decline after ESD/EMR between patients aged ≥80 years and \u003C75 years was marginal (0 .8%–2 .5%), whereas that after laparoscopic (4.8%–5.9%) or open surgery (4.6%–9.4%) was large, except for pancreatic cancer (3 .0%) . Among patients with gastric cancer who underwent laparoscopic or open surgery, the proportion of unexpected readmission tended to be higher in patients aged ≥80 years than in the remaining younger patients (laparoscopic surgery 4 .8% vs 2.3%(p=0 .001); open surgery 7 .3% vs 4 .4%(p\u003C0 .001)) . The postoperative mortality rate was \u003C3%(\u003C10 cases) across all ages and cancer types.  \nConclusions In ESD/EMR, postoperative ADL decline was almost the same between older and younger patients. Laparoscopic or open surgery is associated with increased rates of ADL decline in older patients, especially in those aged ≥80 years. The potential decline in ADLs should be  \nSTRENGTHS AND LIMITATIONS OF THIS STUDY   \n⇒ This study used nationwide data that covered approximately 49% of new cancer cases in Japan.  \n⇒ Activities of daily living (ADL) after oncological surgery were examined by age groups.  \n⇒ Information on ADLs was only available at the time of hospital admission and discharge.  \n⇒ The extent to which doctors’ judgements and patients’ preferences influenced their treatment choice remains unclear.  \n⇒ The impact of in-hospital rehabilitation on ADLs has not been considered.  \ncarefully considered preoperatively to best maintain the patient’s quality of life postsurgery.  \nINTRODUCTION  \nAge is associated with a progressive decline in the functional reserve of multiple organ systems and an increased incidence o","cbCaimgZwU6bbKlL","https://ap.wps.com/l/cbCaimgZwU6bbKlL","pdf",924791,"English","# Abstract\n## Objectives\n## Design\n## Setting\n## Participants\n## Outcome measures\n## Results\n## Conclusions\n# Strengths and limitations of this study\n# Introduction","[{\"question\":\"What was the study’s main objective regarding ADLs after surgery?\",\"answer\":\"To evaluate activities of daily living after oncological surgery in patients with gastrointestinal and hepatobiliary-pancreatic cancers, stratified by age group, using Japan nationwide data.\"},{\"question\":\"Which treatments and patient groups were included in the analysis?\",\"answer\":\"Patients who underwent endoscopic submucosal dissection (ESD), endoscopic mucosal resection (EMR), and laparoscopic or open surgery were included, with outcomes compared across age groups (40–74, 75–79, and ≥80 years).\"},{\"question\":\"How were outcomes measured after surgery?\",\"answer\":\"Outcomes included the proportion of ADL decline at discharge, death, and unexpected readmission within 6 weeks postsurgery, calculated by age group.\"}]","Activities of daily living after surgery among older patients with gastrointestinal and hepatobiliary-pancreatic cancers - a retrospective observational study using nationwide health services utilisation data from Japan | PDF",1790227586,15]