Osamu Yasui
Biostatistician 2, Cardiac Anesthesiology
https://orcid.org/0000-0002-3216-0979All Publications
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Two decades of change: Trends and disparities in breast cancer surgical outcomes.
LIPPINCOTT WILLIAMS & WILKINS. 2026: e12742
View details for DOI 10.1200/JCO.2026.44.16_suppl.e12742
View details for Web of Science ID 001780554000018
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Cystic Fibrosis Heterozygosity as a Risk Factor for Post-ERCP Pancreatitis: Implications for ERCP Risk Stratification in the Cosmos Cohort.
Digestive diseases and sciences
2026
Abstract
Endoscopic retrograde cholangiopantography (ERCP) is widely utilized but carries a risk of post-ERCP pancreatitis (PEP), a major source of morbidity, mortality, and healthcare costs. Although known risk factors exist, the impact of cystic fibrosis (CF) and cystic fibrosis transmembrane conductance regulator (CFTR)-related biology remains incompletely understood. CF affects ~ 30,000 individuals in the U.S. and often involves hepatobiliary disease requiring ERCP. To this end, we aim to determine whether CF heterozygosity carries an elevated risk of PEP following ERCP.An analysis was conducted using patient data obtained from the Epic Cosmos cohort, a large-scale population health research platform developed by Epic Systems Corporation. Cosmos aggregates approximately 300 million patient records from participating centers. We included patients undergoing their first ERCP and who required at least one year of prior clinical observation. CF carrier status and CF diagnosis were ascertained using diagnostic codes. PEP was defined as a diagnosis of non-gallstone pancreatitis within 14 days post-ERCP. Multivariable logistic regression and entropy balancing were used for adjustment.A retrospective analysis of 364,707 patients undergoing 593,660 ERCPs. Of these, 1,074 ERCPs were compared to controls. CF carrier patients were more likely to be female (65.9% vs. 53.9%), older, have prior ERCP (54.0% vs. 39.1%), receive rectal indomethacin (21.1% vs. 14.4%), but less likely to have cholangitis (9.9% vs. 19.6%). The unadjusted PEP rate was significantly higher in CF carriers (40.4% vs. 11.3%, OR = 5.33, p < 0.001). After adjustment, CF carrier status was associated with increased PEP risk (logistic regression: adjusted OR = 2.34, 95% CI: 2.03-2.69; entropy balancing: adjusted OR = 2.13, 95% CI: 1.83-2.48).CF heterozygosity status is independently associated with a substantially increased risk of post-ERCP pancreatitis, suggesting that CFTR dysfunction may heighten pancreatic vulnerability during ERCP. Clinically, CF carriers may represent an underrecognized high-risk group who could benefit from more intensive pre-procedural risk assessment and optimized prophylactic strategies.
View details for DOI 10.1007/s10620-026-09977-5
View details for PubMedID 42166038
View details for PubMedCentralID 11602798
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EXPLAINABLE MACHINE LEARNING PREDICTION OF CARDIOVASCULAR MORTALITY IN US ADULTS WITH DIABETES: INSIGHTS FROM NHANES 2007-2018
ELSEVIER SCIENCE INC. 2026: A321
View details for Web of Science ID 001754472500025
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Machine Learning-Based Analysis of Behavioral and Social Determinants of Cardiovascular Mortality in Adults With Diabetes
LIPPINCOTT WILLIAMS & WILKINS. 2026: ATH842
View details for DOI 10.1161/cir.153.suppl_1.TH842
View details for Web of Science ID 001756041200006
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Patient-centered outcomes according to cancer status in cardiac surgery patients: a population-based cohort study.
British journal of cancer
2026
Abstract
More cancer survivors are undergoing cardiac surgery, but their postoperative outcomes remain poorly understood. We aimed to describe the incidence and predictors of postoperative major adverse cardiovascular events (MACE) and patient-defined cardiovascular and non-cardiovascular events (PACE) by cancer status.We conducted a retrospective cohort study (2016-2022) among U.S. adults (≥18 years) undergoing cardiac surgery in MarketScan and Medicare databases. Co-primary outcomes were MACE (stroke, heart failure, myocardial infarction, repeat revascularization) and PACE (stroke, heart failure, new-onset dialysis, long-term care admission, ventilator-dependence). Cox regression evaluated the association of cancer status with postoperative outcomes.Among 61,581 patients (74.1% male; mean age 61 ± 10.9 years), 5381 (8.7%) had cancer. Although cancer patients exhibited higher unadjusted MACE and PACE over 2.0 ± 1.7 years (p < 0.001), multivariable analyses showed no significant association between cancer status and MACE or PACE at 30-days or at long-term follow-up MACE (aHR 1.05, 95%CI [0.99-1.10]) and PACE (aHR 1.02, [0.96-1.08]). Blood (aHR 1.13, [1.01-1.26]) and lung cancers (aHR 1.32, [1.08-1.62]) were associated with increased MACE risk, while digestive (aHR 1.17, [1.00-1.36]) and blood (aHR 1.14, [1.01-1.28]) cancers were linked to higher PACE risk. Factors more strongly predictive of PACE than MACE included older age, female sex and valvular/complex surgeries.Cancer status alone should not preclude cardiac surgery. A personalised, multidisciplinary approach may help optimise outcomes and better manage risks in this high-risk population.
View details for DOI 10.1038/s41416-026-03358-5
View details for PubMedID 41840128
View details for PubMedCentralID 5491406
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The Impact of English Language Proficiency on Outcomes After Cardiovascular Surgery
LIPPINCOTT WILLIAMS & WILKINS. 2025
View details for DOI 10.1161/circ.152.suppl_3.4344937
View details for Web of Science ID 001613781900006
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Cystic Fibrosis Carrier Status: A genetic predisposition to post-ERCP pancreatitis.
Gastrointestinal endoscopy
2025
Abstract
Cystic Fibrosis (CF) is recessive and due to CFTR gene mutations. CFTR mutation heterozygotes (CF Carriers, CFC) are predisposed to CF-associated conditions, including pancreatitis. Post Endoscopic Retrograde Cholangiopancreatography (ERCP) pancreatitis (PEP) is a common adverse event following ERCP. Here we evaluate whether CFC status predisposes to PEP.This single-center retrospective cohort study evaluated CFC and presumed non-CF Carrier (N-CFC) patients undergoing index ERCP. We analyzed demographics, indications, interventions, and adverse events using descriptive statistics.Among 3,057 patients, 249 were CFC. No significant differences were found in demographics or ERCP characteristics between CFC and N-CFC. However, the rate of PEP was significantly higher in CFC (17.7% vs. 4.6%, p<0.001), while other adverse events did not differ.CFC status appears to increase predisposition to PEP, highlighting the potential for improved pre-procedural risk assessment and prophylaxis and opportunities for further study to identify novel PEP prophylactic strategies.
View details for DOI 10.1016/j.gie.2025.10.012
View details for PubMedID 41083013
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Cold Snare Polypectomy in Pediatric Polyposis: A Multicenter Experience.
Children (Basel, Switzerland)
2025; 12 (3)
Abstract
Background: Cold snare polypectomy (CSP) is a well-established and recommended technique in adult gastroenterology for the safe, efficient and complete removal of nonpedunculated lesions up to 10 mm, with piecemeal excision possible for larger lesions. However, the application of CSP in pediatric patients remains underexplored. This study summarizes a multicenter experience of CSP in pediatric polyposis patients, focusing on safety, efficacy and clinical outcomes. Methods: This retrospective study was conducted at two pediatric tertiary centers, encompassing patients aged 1 to 21 years with polyposis who underwent colonoscopy with CSP and hot snare polypectomy (HSP) between January 2022 and January 2023. Patient demographics, procedure characteristics, polyp details and clinical outcomes were analyzed. Results: A total of 477 CSPs were performed in 63 colonoscopies. Satisfactory bowel preparation was noted in 79% of procedures, with a pooled mean procedure duration of 52 min and cecal intubation achieved in 98%. Polyps resected by CSP ranged from 3 to 70 mm in size and were predominantly left-sided. Tissue retrieval was complete in 94% of cases and partial in 5%. Mild intraprocedural bleeding occurred in 25% of CSP cases, requiring endoclip placement in 19%, with no post-procedural bleeding or significant complications observed. Comparatively, CSP demonstrated favorable bleeding rates relative to HSP. At two-week follow-up, four patients required emergency evaluation for unrelated complaints, but with no adverse events attributed to CSP. Conclusions: CSP is a safe and effective technique for the removal of sessile polyps in pediatric patients with polyposis. Mild intraprocedural bleeding, when observed, was effectively managed with standard hemostatic techniques. These findings support the potential of CSP as a preferred modality for sessile polyp removal in pediatric patients, though further research is warranted to define its role across broader pediatric populations and practice settings.
View details for DOI 10.3390/children12030291
View details for PubMedID 40150574
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Magnetic endoscopic imaging in pediatric colonoscopy: A positive impact on procedure completion rate and procedure times.
Journal of pediatric gastroenterology and nutrition
2025
Abstract
To assess the impact of magnetic endoscopic imaging (MEI) on pediatric colonoscopy.We analyzed demographics, procedure completion, procedure times, complications, and whether or not MEI was used for all colonoscopies between April 27, 2023, and January 18, 2024. MEI was available for every case but used at the endoscopist's discretion. Attendings were surveyed on the frequency and duration of interventions during fellow-performed colonoscopies.We analyzed 310 colonoscopies, 113 (36%) of which used MEI. The average patient age was 13.8 years (range 5 months to 23 years). For the aggregate sample and attending-performed cases, there were fewer males in the groups that used MEI (p < 0.01). There were no other statistically significant differences in demographics or procedure indication when MEI was used. Terminal ileum (TI) intubation rate was higher when MEI was used in the aggregate sample (p = 0.02) and for fellow-performed cases (p = 0.04). TI intubation times and total procedure times were quicker when MEI was used in the aggregate sample and in both strata of attending-performed cases and fellow-performed cases (p < 0.001). One complication was reported in an attending-performed case that did not use MEI. Of the 145 fellow-performed procedures, 98 (68%) had completed surveys, 36 (36%) of which used MEI. There was no statistically significant difference in the number (p = 0.89) or duration (p = 0.96) of attending interventions when MEI was used.MEI use was associated with higher TI intubation rates, faster TI intubation, and shorter total procedure times. MEI may be a valuable adjunctive tool for pediatric endoscopists.
View details for DOI 10.1002/jpn3.70011
View details for PubMedID 39968857
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Plasmapheresis in ANCA-Associated Vasculitis with Active Kidney Involvement in the United States (2016-2020): A Cross-Sectional Study.
Kidney360
2024
Abstract
Plasmapheresis is currently recommended when antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) presents with severe kidney and/or lung involvement. This cross-sectional study aimed at describing characteristics of hospitalized patients diagnosed with AAV with severe kidney involvement undergoing plasmapheresis in the US.We defined the study population as adults hospitalized for active kidney involvement with a new diagnosis of AAV (by subtype or unspecified). We established the cohort from the 2016-2020 National Inpatient Sample by ICD-10-CM codes. In this cross-sectional study, we described demographic and clinical characteristics, associated inpatient procedures, lengths of stay, hospital costs, and disposition at discharge comparing patients treated and not treated with plasmapheresis.We identified a total of 975 cases of hospitalized AAV with acute kidney involvement in the US treated by plasmapheresis over the 5-year period. Demographic characteristics of patients who received plasmapheresis were similar to those in patients who did not (n=5670). There were no regional differences in the proportion of patients who received plasmapheresis; however, plasmapheresis was deployed more frequently among patients admitted to urban teaching hospitals relative to rural and non-teaching hospitals. Cases treated with plasmapheresis were more likely to have had acute kidney injury (AKI) (96% vs. 90%, p=0.0007), AKI requiring dialysis (52% vs 16%, p<0.001), hypoxia (40% vs. 16%, p<0.0001), and respiratory failure requiring mechanical ventilation (13% vs. 3%, p=0.0003).During 2016-2020, plasmapheresis was deployed in approximately 20% of patients being admitted for AAV and acute kidney involvement in the US. As standards of care and practice evolve, the role of plasmapheresis in the management of AAV with acute kidney involvement will require further study.
View details for DOI 10.34067/KID.0000000000000496
View details for PubMedID 39008365