Indication for Surgery and the Risk of Postoperative Nausea and Vomiting After Craniotomy
Bibliographic record
Abstract
BACKGROUND: The primary hypothesis of the study is that acoustic neuroma (AN) surgery and microvascular decompression (MVD) of cranial nerves increase the risk of postoperative nausea and vomiting (PONV). METHODS: We designed a retrospective case-control study matched on age, sex, and year of surgery (≤2005 and >2005). Year of surgery was noted as a potential confounder, because routine antiemetic prophylaxis was strongly encouraged at the study site in 2005. Cases of PONV in the recovery room were matched to controls in a 1:2 manner using a perioperative database. Charts were then reviewed for the following data: American Society of Anesthesiologists grade, smoking status, craniotomy location, craniotomy indication, and type of anesthetic administered. RESULTS: The final analysis included 117 cases that were matched with 185 controls. Patients had a mean age of 50 years (SD=13), and 65% were female. Overall, the majority of craniotomies were supratentorial (70%) and performed for tumor resection (41%). On multivariable analysis, MVD [odds ratio (OR)=6.7; 95% confidence interval (CI), 2.0-22.7; P=0.002], AN (OR=3.3; 95% CI, 1.0-11.0; P=0.05), and epilepsy surgery (OR=2.8; 95% CI, 1.1-7.5; P=0.04) were associated with an increased likelihood of PONV when compared with tumor surgery. There was effect modification of total intravenous anesthesia by location of surgery (P-interaction=0.02). The benefit of total intravenous anesthesia on PONV was observed in supratentorial (OR=0.41; 95% CI, 0.17-0.96; P=0.04) but not infratentorial location (OR=2.6; 95% CI, 0.78-8.7; P=0.11). CONCLUSIONS: MVD and AN resection were associated with an increased likelihood of PONV compared with craniotomies performed for other tumor resection.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".