Impact of Living in a Food Desert on Complications After Fracture Surgery
Notice bibliographique
Résumé
BACKGROUND: Food deserts-communities with limited access to healthy food-have been linked with poor surgical outcomes; however, their impact on orthopaedic trauma outcomes remains unknown. The aims of this study were to determine the prevalence of food desert residency among orthopaedic trauma patients and to investigate the impact of food desert residency on the rate of unplanned reoperation with use of a large, high-quality, prospectively collected dataset with adjudicated outcomes. We hypothesized that orthopaedic trauma patients would reside in food deserts at a higher rate than the general U.S. population and that living in a food desert would be independently associated with an increased rate of unplanned reoperation. METHODS: We included all patients from the Aqueous-PREP and PREPARE trials who had documented ZIP codes. The primary outcome was unplanned reoperation within 1 year, and the secondary outcomes included the reasons for reoperation. Residing in a food desert was the independent variable and was defined by the United States Department of Agriculture (USDA). Census tracts were converted to ZIP codes in order to assign food access for an individual's residence with use of the USDA Food Access Research Atlas. RESULTS: Of the 2,607 patients included, 1,453 (55.7%) lived in a ZIP code containing a food desert compared with 49% of the U.S. population. Patients residing in a food desert were 42% female, 26.6% non-White, and 64% employed prior to injury, whereas patients not residing in a food desert were 41% female, 15% non-White, and 63% employed prior to injury, all of which was collected via patient self-report. Multivariable analysis demonstrated that living in a food desert was independently associated with 40% higher odds of unplanned reoperation (odds ratio [OR], 1.40; 95% confidence interval [CI], 1.06 to 1.85; p = 0.019). This was driven by reoperation for delayed union or nonunion (OR, 1.75; 95% CI, 1.19 to 2.57; p = 0.004) and reoperation for a wound-healing complication (OR, 1.60; 95% CI, 1.01 to 2.54; p = 0.044). CONCLUSIONS: This study found a strong association between residing in a ZIP code containing a food desert and an increased rate of unplanned reoperation, which was primarily driven by delayed union or nonunion and wound-healing complications. Addressing nutritional deficiencies in this population may help to effectively triage the use of health-care resources. Further research should focus on clarifying specific deficiencies and assessing the effectiveness of targeted interventions. LEVEL OF EVIDENCE: Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,002 | 0,013 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,001 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,001 | 0,000 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,000 | 0,001 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,002 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».