Association between Preoperative Psychiatric Morbidities and Mortality after Oncologic Surgery: A Nationwide Cohort Study from 2002 to 2019 in South Korea
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design and Ethical Statement
2.2. Study Population
2.3. Preoperative Psychiatric Morbidity (Exposure Variable)
2.4. Study Endpoint
2.5. Covariates
2.6. Statistical Methodology
3. Results
3.1. Study Population
3.2. Results of 30-Day Mortality
3.3. Subgroup Analyses
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
- Bray, F.; Jemal, A.; Grey, N.; Ferlay, J.; Forman, D. Global cancer transitions according to the Human Development Index (2008–2030): A population-based study. Lancet Oncol. 2012, 13, 790–801. [Google Scholar] [CrossRef]
- Foreman, K.J.; Marquez, N.; Dolgert, A.; Fukutaki, K.; Fullman, N.; McGaughey, M.; Pletcher, M.A.; Smith, A.E.; Tang, K.; Yuan, C.W.; et al. Forecasting life expectancy, years of life lost, and all-cause and cause-specific mortality for 250 causes of death: Reference and alternative scenarios for 2016-40 for 195 countries and territories. Lancet 2018, 392, 2052–2090. [Google Scholar] [CrossRef] [Green Version]
- Global Burden of Disease 2019 Cancer Collaboration; Kocarnik, J.M.; Compton, K.; Dean, F.E.; Fu, W.; Gaw, B.L.; Harvey, J.D.; Henrikson, H.J.; Lu, D.; Pennini, A.; et al. Cancer Incidence, Mortality, Years of Life Lost, Years Lived with Disability, and Disability-Adjusted Life Years for 29 Cancer Groups From 2010 to 2019: A Systematic Analysis for the Global Burden of Disease Study 2019. JAMA Oncol. 2022, 8, 420–444. [Google Scholar] [CrossRef]
- Wyld, L.; Audisio, R.A.; Poston, G.J. The evolution of cancer surgery and future perspectives. Nat. Rev. Clin. Oncol. 2015, 12, 115–124. [Google Scholar] [CrossRef]
- Sullivan, R.; Alatise, O.I.; Anderson, B.O.; Audisio, R.; Autier, P.; Aggarwal, A.; Balch, C.; Brennan, M.F.; Dare, A.; D’Cruz, A.; et al. Global cancer surgery: Delivering safe, affordable, and timely cancer surgery. Lancet Oncol. 2015, 16, 1193–1224. [Google Scholar] [CrossRef]
- Mehta, R.D.; Roth, A.J. Psychiatric considerations in the oncology setting. CA Cancer J. Clin. 2015, 65, 300–314. [Google Scholar] [CrossRef]
- Kisely, S.; Crowe, E.; Lawrence, D. Cancer-related mortality in people with mental illness. JAMA Psychiatry 2013, 70, 209–217. [Google Scholar] [CrossRef] [Green Version]
- Grassi, L.; Riba, M. Cancer and severe mental illness: Bi-directional problems and potential solutions. Psychooncology 2020, 29, 1445–1451. [Google Scholar] [CrossRef] [PubMed]
- Chaturvedi, S.K. Psychiatric oncology: Cancer in mind. Indian J. Psychiatry 2012, 54, 111–118. [Google Scholar] [CrossRef] [PubMed]
- Wikman, A.; Ljung, R.; Johar, A.; Hellstadius, Y.; Lagergren, J.; Lagergren, P. Psychiatric morbidity and survival after surgery for esophageal cancer: A population-based cohort study. J. Clin. Oncol. 2015, 33, 448–454. [Google Scholar] [CrossRef] [PubMed]
- van den Berg, I.; Buettner, S.; van den Braak, R.; Ultee, K.H.J.; Lingsma, H.F.; van Vugt, J.L.A.; Ijzermans, J.N.M. Low Socioeconomic Status Is Associated with Worse Outcomes after Curative Surgery for Colorectal Cancer: Results from a Large, Multicenter Study. J. Gastrointest. Surg. 2020, 24, 2628–2636. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Chang, C.-M.; Yin, W.-Y.; Wei, C.-K.; Wu, C.-C.; Su, Y.-C.; Yu, C.-H.; Lee, C.-C. Adjusted age-adjusted Charlson comorbidity index score as a risk measure of perioperative mortality before cancer surgery. PLoS ONE 2016, 11, e0148076. [Google Scholar]
- Steenkamp, M.M.; Corry, N.H.; Qian, M.; Li, M.; McMaster, H.S.; Fairbank, J.A.; Stander, V.A.; Hollahan, L.; Marmar, C.R. Prevalence of psychiatric morbidity in United States military spouses: The Millennium Cohort Family Study. Depress. Anxiety 2018, 35, 815–829. [Google Scholar] [CrossRef] [PubMed]
- Lee, J.; Kim, H.; Hong, J.P.; Cho, S.J.; Lee, J.Y.; Jeon, H.J.; Kim, B.S.; Chang, S.M. Trends in the Prevalence of Major Depressive Disorder by Sociodemographic Factors in Korea: Results from Nationwide General Population Surveys in 2001, 2006, and 2011. J. Korean Med. Sci. 2021, 36, e244. [Google Scholar] [CrossRef]
- Kiecolt-Glaser, J.K.; Glaser, R. Depression and immune function: Central pathways to morbidity and mortality. J. Psychosom. Res. 2002, 53, 873–876. [Google Scholar] [CrossRef]
- Marrie, R.A.; Walld, R.; Bolton, J.M.; Sareen, J.; Patten, S.B.; Singer, A.; Lix, L.M.; Hitchon, C.A.; El-Gabalawy, R.; Katz, A.; et al. Psychiatric comorbidity increases mortality in immune-mediated inflammatory diseases. Gen. Hosp. Psychiatry 2018, 53, 65–72. [Google Scholar] [CrossRef] [PubMed]
- Alazawi, W.; Pirmadjid, N.; Lahiri, R.; Bhattacharya, S. Inflammatory and Immune Responses to Surgery and Their Clinical Impact. Ann. Surg. 2016, 264, 73–80. [Google Scholar] [CrossRef]
- Goldman, L.S. Comorbid medical illness in psychiatric patients. Curr. Psychiatry Rep. 2000, 2, 256–263. [Google Scholar] [CrossRef]
- Goldman, M.L.; Mangurian, C.; Corbeil, T.; Wall, M.M.; Tang, F.; Haselden, M.; Essock, S.M.; Frimpong, E.; Mascayano, F.; Radigan, M.; et al. Medical comorbid diagnoses among adult psychiatric inpatients. Gen. Hosp. Psychiatry 2020, 66, 16–23. [Google Scholar] [CrossRef]
- Herbeck, D.M.; Fitek, D.J.; Svikis, D.S.; Montoya, I.D.; Marcus, S.C.; West, J.C. Treatment compliance in patients with comorbid psychiatric and substance use disorders. Am. J. Addict. 2005, 14, 195–207. [Google Scholar] [CrossRef]
- Cuijpers, P.; Vogelzangs, N.; Twisk, J.; Kleiboer, A.; Li, J.; Penninx, B.W. Is excess mortality higher in depressed men than in depressed women? A meta-analytic comparison. J. Affect. Disord. 2014, 161, 47–54. [Google Scholar] [CrossRef]
- Kim, G.E.; Jo, M.W.; Shin, Y.W. Increased prevalence of depression in South Korea from 2002 to 2013. Sci. Rep. 2020, 10, 16979. [Google Scholar] [CrossRef] [PubMed]
- Kisely, S.; Sadek, J.; MacKenzie, A.; Lawrence, D.; Campbell, L.A. Excess cancer mortality in psychiatric patients. Can. J. Psychiatry 2008, 53, 753–761. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Yun, H.S.; Kim, J.H.; Bae, S.M. Depressive Symptoms and Mortality among Middle-Aged and Older Adults in South Korea. Psychiatry Investig. 2022, 19, 302–310. [Google Scholar] [CrossRef] [PubMed]
- Iglay, K.; Santorelli, M.L.; Hirshfield, K.M.; Williams, J.M.; Rhoads, G.G.; Lin, Y.; Demissie, K. Impact of Preexisting Mental Illness on All-Cause and Breast Cancer-Specific Mortality in Elderly Patients with Breast Cancer. J. Clin. Oncol. 2017, 35, 4012–4018. [Google Scholar] [CrossRef] [PubMed]
- Arffman, M.; Manderbacka, K.; Suvisaari, J.; Koivunen, J.; Lumme, S.; Keskimaki, I.; Ahlgren-Rimpilainen, A.; Pukkala, E. The impact of severe mental illness on lung cancer mortality of patients with lung cancer in Finland in 1990-2013: A register-based cohort study. Eur. J. Cancer 2019, 118, 105–111. [Google Scholar] [CrossRef]
- Wright, A.E.; Sheehan, E.; Qeadan, F.; Stalter, L.; Saeed, A.I. Preexisting psychological illness and its association with mortality in lung cancer patients with access to support resources. Clin. Respir. J. 2022, 16, 750–755. [Google Scholar] [CrossRef]
- Draeger, D.L.; Sievert, K.D.; Hakenberg, O.W. Analysis of psychosocial stress factors in patients with renal cancer. Ther. Adv. Urol. 2018, 10, 175–182. [Google Scholar] [CrossRef]
- Damhuis, R.A.; Wijnhoven, B.P.; Plaisier, P.W.; Kirkels, W.J.; Kranse, R.; van Lanschot, J.J. Comparison of 30-day, 90-day and in-hospital postoperative mortality for eight different cancer types. Br. J. Surg. 2012, 99, 1149–1154. [Google Scholar] [CrossRef]
Variable | Number (%) | Mean (SD) |
---|---|---|
Age, years | 58.3 (13.6) | |
1–19 | 3553 (0.4) | |
20–39 | 76,764 (8.1) | |
40–59 | 414,138 (43.8) | |
60–79 | 406,976 (43.1) | |
≥80 | 43,363 (4.6) | |
Sex, male | 423,522 (44.8) | |
Residence at surgery | ||
Urban area | 314,147 (33.3) | |
Rural area | 630,647 (66.7) | |
Household income level | ||
Medical aid program | 34,775 (3.7) | |
Q1 | 160,047 (16.9) | |
Q2 | 164,963 (17.5) | |
Q3 | 224,805 (23.8) | |
Q4 | 341,344 (36.1) | |
Unknown | 18,860 (2.0) | |
Having a job at surgery | 537,838 (56.9) | |
Disability at surgery | ||
Mild to moderate | 59,224 (6.3) | |
Severe | 28,316 (3.0) | |
Preoperative CCI, points | 3.4 (2.1) | |
0–2 | 498,904 (52.8) | |
3–4 | 269,221 (28.5) | |
5–6 | 33,793 (3.6) | |
7–8 | 112,573 (11.9) | |
≥9 | 30,303 (3.2) | |
Preoperative psychiatric morbidity | 24,370 (2.6) | |
Depression | 13,312 (1.4) | |
Anxiety disorder | 12,082 (1.3) | |
Substance abuse | 816 (0.1) | |
PTSD | 16 (0.0) | |
LOS, days | 13.4 (9.6) | |
30-day postoperative mortality | 5490 (0.6) | |
Type of cancer | ||
Breast cancer | 201,477 (21.3) | |
Laryngeal cancer | 1810 (0.2) | |
Lung cancer | 85,055 (9.0) | |
Thyroid cancer | 137,639 (14.6) | |
Gastric cancer | 217,200 (23.0) | |
Colorectal cancer | 109,774 (11.6) | |
Esophageal cancer | 13,379 (1.4) | |
Liver cancer | 69,427 (7.3) | |
Pancreatic cancer | 14,738 (1.6) | |
Kidney cancer | 47,907 (5.1) | |
Bladder cancer | 9250 (1.0) | |
Testicular cancer | 3565 (0.4) | |
Prostate cancer | 2441 (0.3) | |
Vulvar cancer | 924 (0.1) | |
Uterine cancer | 8773 (0.9) | |
Brain cancer | 21,435 (2.3) | |
Year of surgery | ||
2002 | 22,397 (2.4) | |
2003 | 25,531 (2.7) | |
2004 | 28,108 (3.0) | |
2005 | 30,156 (3.2) | |
2006 | 33,471 (3.5) | |
2007 | 36,482 (3.9) | |
2008 | 53,486 (5.7) | |
2009 | 57,517 (6.1) | |
2010 | 60,670 (6.4) | |
2011 | 66,423 (7.0) | |
2012 | 67,448 (7.1) | |
2013 | 67,685 (7.2) | |
2014 | 67,830 (7.2) | |
2015 | 69,185 (7.3) | |
2016 | 72,175 (7.6) | |
2017 | 62,735 (6.6) | |
2018 | 60,217 (6.4) | |
2019 | 63,278 (6.7) |
Variable | Preoperative-PY Group n = 24,370 | No-PY Group n = 920,424 | p-Value |
---|---|---|---|
Age, years | 62.3 (13.3) | 58.2 (13.6) | <0.001 |
Sex, male | 11,015 (45.2) | 412,507 (44.8) | 0.237 |
Residence at surgery | 0.680 | ||
Urban area | 8133 (33.4) | 306,014 (33.2) | |
Rural area | 16,237 (66.6) | 614,410 (66.8) | |
Household income level | <0.001 | ||
Medical aid program | 2279 (9.4) | 32,496 (3.5) | |
Q1 | 4092 (16.8) | 155,955 (16.9) | |
Q2 | 4150 (17.0) | 160,813 (17.5) | |
Q3 | 5365 (22.0) | 219,440 (23.8) | |
Q4 | 8042 (33.0) | 333,302 (36.2) | |
Unknown | 442 (1.8) | 18,418 (2.0) | |
Having a job at surgery | 12,406 (50.9) | 525,432 (57.1) | <0.001 |
Disability at surgery | <0.001 | ||
Mild to moderate | 2265 (9.3) | 56,959 (6.2) | |
Severe | 1652 (6.8) | 26,664 (2.9) | |
Preoperative CCI, points | 4.5 (2.6) | 3.3 (2.1) | <0.001 |
LOS, days | 21.0 (15.0) | 13.2 (9.4) | <0.001 |
30-day mortality | 304 (1.2) | 5186 (0.6) | <0.001 |
Type of cancer | |||
Breast cancer | 5774 (23.7) | 195,703 (21.3) | <0.001 |
Laryngeal cancer | 125 (0.5) | 1685 (0.2) | <0.001 |
Lung cancer | 3399 (13.9) | 81,656 (8.9) | <0.001 |
Thyroid cancer | 1428 (5.9) | 136,211 (14.8) | <0.001 |
Gastric cancer | 4323 (17.7) | 212,877 (23.1) | <0.001 |
Colorectal cancer | 3172 (13.0) | 106,602 (11.6) | <0.001 |
Esophageal cancer | 598 (2.5) | 12,781 (1.4) | <0.001 |
Liver cancer | 1577 (6.5) | 67,850 (7.4) | <0.001 |
Pancreatic cancer | 533 (2.2) | 14,205 (1.5) | <0.001 |
Kidney cancer | 1148 (4.7) | 46,759 (5.1) | 0.009 |
Bladder cancer | 376 (1.5) | 8874 (1.0) | <0.001 |
Testicular cancer | 37 (0.2) | 3528 (0.4) | <0.001 |
Prostate cancer | 79 (0.3) | 2362 (0.3) | 0.040 |
Vulvar cancer | 33 (0.1) | 891 (0.1) | 0.072 |
Uterine cancer | 349 (1.4) | 8424 (0.9) | <0.001 |
Brain cancer | 1419 (5.8) | 20,016 (2.2) | <0.001 |
Variable | aOR (95% CI) | p-Value |
---|---|---|
Preoperative-PY group (vs no-PY group) (model 1) | 1.23 (1.09, 1.39) | 0.001 |
Preoperative-PY group, in detail (vs no-PY group) (model 2) | ||
Depression | 0.93 (0.78, 1.11) | 0.405 |
Anxiety disorder | 1.38 (1.18, 1.62) | <0.001 |
Substance abuse | 2.10 (1.34, 3.31) | 0.001 |
PTSD | 0.00 (0.00-) | 0.999 |
Other covariates in model 1 (below) | ||
Age, years | 1.06 (1.06, 1.07) | <0.001 |
Sex, male (vs female) | 1.58 (1.49, 1.68) | <0.001 |
Residence at surgery | ||
Urban area | 1 | |
Rural area | 1.12 (1.06, 1.19) | <0.001 |
Household income level | ||
Medical aid program | 1 | |
Q1 | 0.61 (0.55, 0.69) | <0.001 |
Q2 | 0.63 (0.56, 0.71) | <0.001 |
Q3 | 0.57 (0.51, 0.63) | <0.001 |
Q4 | 0.49 (0.44, 0.54) | <0.001 |
Unknown | 0.53 (0.43, 0.66) | <0.001 |
Having a job at surgery | 0.97 (0.92, 1.03) | 0.345 |
Disability at surgery | ||
Mild to moderate | 1.02 (0.93, 1.11) | 0.684 |
Severe | 1.53 (1.38, 1.70) | <0.001 |
Preoperative CCI, points | 1.19 (1.18, 1.21) | <0.001 |
Type of cancer | ||
Breast cancer | 0.07 (0.04, 0.11) | <0.001 |
Laryngeal cancer | 0.39 (0.21, 0.74) | 0.004 |
Lung cancer | 1.02 (0.74, 1.41) | 0.918 |
Thyroid cancer | 0.12 (0.08, 0.19) | <0.001 |
Gastric cancer | 0.63 (0.46, 0.87) | 0.005 |
Colorectal cancer | 1.60 (1.16, 2.20) | 0.004 |
Esophageal cancer | 1.67 (1.18, 2.35) | 0.004 |
Liver cancer | 1.12 (0.81, 1.55) | 0.496 |
Pancreatic cancer | 1.43 (1.01, 2.02) | 0.043 |
Kidney cancer | 0.51 (0.36, 0.73) | <0.001 |
Bladder cancer | 0.86 (0.58, 1.26) | 0.428 |
Testicular cancer | 0.85 (0.44, 1.64) | 0.636 |
Prostate cancer | 0.28 (0.12, 0.62) | 0.002 |
Vulvar cancer | 0.00 (0.00-) | 0.990 |
Uterine cancer | 1.44 (1.05, 1.98) | 0.024 |
Brain cancer | 2.45 (1.76, 3.43) | <0.001 |
Year of surgery | ||
2002 | 1 | |
2003 | 0.89 (0.71, 1.11) | 0.294 |
2004 | 0.86 (0.69, 1.06) | 0.156 |
2005 | 0.78 (0.63, 0.97) | 0.024 |
2006 | 0.74 (0.60, 0.92) | 0.005 |
2007 | 0.90 (0.74, 1.10) | 0.314 |
2008 | 0.85 (0.70, 1.03) | 0.101 |
2009 | 0.93 (0.77, 1.12) | 0.423 |
2010 | 0.82 (0.68, 0.99) | 0.039 |
2011 | 0.88 (0.73, 1.07) | 0.196 |
2012 | 0.82 (0.68, 0.99) | 0.044 |
2013 | 0.67 (0.55, 0.82) | <0.001 |
2014 | 0.74 (0.61, 0.89) | 0.002 |
2015 | 0.72 (0.60, 0.87) | 0.001 |
2016 | 0.58 (0.48, 0.70) | <0.001 |
2017 | 0.61 (0.51, 0.74) | <0.001 |
2018 | 0.61 (0.51, 0.74) | <0.001 |
2019 | 0.55 (0.46, 0.67) | <0.001 |
Variable | aOR (95% CI) | p-Value |
---|---|---|
Breast cancer (n = 5774) | ||
Preoperative-PY group (vs no-PY group) | 3.31 (1.36, 8.07) | 0.009 |
Laryngeal cancer (n = 125) | ||
Preoperative-PY group (vs no-PY group) | 0.00 (0.00-) | 0.996 |
Lung cancer (n = 3399) | ||
Preoperative-PY group (vs no-PY group) | 1.54 (1.19, 2.01) | 0.001 |
Thyroid cancer (n = 1428) | ||
Preoperative-PY group (vs no-PY group) | 1.62 (0.37, 7.01) | 0.521 |
Gastric cancer (n = 4323) | ||
Preoperative-PY group (vs no-PY group) | 1.24 (0.93, 1.65) | 0.151 |
Colorectal cancer (n = 3172) | ||
Preoperative-PY group (vs no-PY group) | 1.12 (0.90, 1.40) | 0.303 |
Esophageal cancer (n = 598) | ||
Preoperative-PY group (vs no-PY group) | 0.92 (0.52, 1.64) | 0.776 |
Liver cancer (n = 1577) | ||
Preoperative-PY group (vs no-PY group) | 1.40 (0.96, 2.06) | 0.081 |
Pancreatic cancer (n = 533) | ||
Preoperative-PY group (vs no-PY group) | 1.31 (0.70, 2.44) | 0.402 |
Kidney cancer (n = 1148) | ||
Preoperative-PY group (vs no-PY group) | 1.87 (1.06, 3.31) | 0.031 |
Bladder cancer (n = 376) | ||
Preoperative-PY group (vs no-PY group) | 1.39 (0.61, 3.13) | 0.432 |
Testicular cancer (n = 37) | ||
Preoperative-PY group (vs no-PY group) | 0.00 (0.00-) | 0.997 |
Prostate cancer (n = 79) | ||
Preoperative-PY group (vs no-PY group) | 0.00 (0.00-) | 0.996 |
Vulvar cancer (n = 33) | ||
Preoperative-PY group (vs no-PY group) | 0.00 (0.00-) | 0.999 |
Uterine cancer (n = 349) | ||
Preoperative-PY group (vs no-PY group) | 1.13 (0.26, 4.93) | 0.873 |
Brain cancer (n = 1419) | ||
Preoperative-PY group (vs no-PY group) | 0.82 (0.33, 1.75) | 0.605 |
Variable | aOR (95% CI) | p-Value |
---|---|---|
Age: 1–19 years old | ||
Preoperative-PY group (vs no-PY group) | 0.00 (0.00-) | 0.997 |
Age: 20–39 years old | ||
Preoperative-PY group (vs no-PY group) | 0.52 (0.07, 3.85) | 0.526 |
Age: 40–59 years old | ||
Preoperative-PY group (vs no-PY group) | 1.66 (1.23, 2.24) | 0.001 |
Age: ≥80 years old | ||
Preoperative-PY group (vs no-PY group) | 1.26 (1.08, 1.47) | 0.004 |
Sex: Male | ||
Preoperative-PY group (vs no-PY group) | 1.32 (1.15, 1.52) | <0.001 |
Sex: Female | ||
Preoperative-PY group (vs no-PY group) | 1.09 (0.87, 1.36) | 0.468 |
Preoperative CCI: 0–2 | ||
Preoperative-PY group (vs no-PY group) | 1.19 (0.71, 1.98) | 0.517 |
Preoperative CCI: 3–4 | ||
Preoperative-PY group (vs no-PY group) | 1.41 (1.17, 1.72) | <0.001 |
Preoperative CCI: 5–6 | ||
Preoperative-PY group (vs no-PY group) | 0.68 (0.41, 1.02) | 0.062 |
Preoperative CCI: 7–8 | ||
Preoperative-PY group (vs no-PY group) | 1.62 (1.23, 2.13) | 0.001 |
Preoperative CCI: ≥9 | ||
Preoperative-PY group (vs no-PY group) | 0.98 (0.76, 1.26) | 0.851 |
Disclaimer/Publisher’s Note: The statements, opinions and data contained in all publications are solely those of the individual author(s) and contributor(s) and not of MDPI and/or the editor(s). MDPI and/or the editor(s) disclaim responsibility for any injury to people or property resulting from any ideas, methods, instructions or products referred to in the content. |
© 2023 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
Share and Cite
Oh, T.-K.; Park, H.-Y.; Song, I.-A. Association between Preoperative Psychiatric Morbidities and Mortality after Oncologic Surgery: A Nationwide Cohort Study from 2002 to 2019 in South Korea. J. Pers. Med. 2023, 13, 1069. https://doi.org/10.3390/jpm13071069
Oh T-K, Park H-Y, Song I-A. Association between Preoperative Psychiatric Morbidities and Mortality after Oncologic Surgery: A Nationwide Cohort Study from 2002 to 2019 in South Korea. Journal of Personalized Medicine. 2023; 13(7):1069. https://doi.org/10.3390/jpm13071069
Chicago/Turabian StyleOh, Tak-Kyu, Hye-Yoon Park, and In-Ae Song. 2023. "Association between Preoperative Psychiatric Morbidities and Mortality after Oncologic Surgery: A Nationwide Cohort Study from 2002 to 2019 in South Korea" Journal of Personalized Medicine 13, no. 7: 1069. https://doi.org/10.3390/jpm13071069