Postoperative Medical Complications Associated with Anesthesia in Older Adults with Dementia
Bibliographic record
Abstract
OBJECTIVES: To examine the association between anesthetic technique and postoperative complications in older adults with dementia undergoing hip fracture surgery. DESIGN: Population-based, retrospective cohort study. SETTING: Ontario, Canada. PARTICIPANTS: All older adults with dementia who underwent surgery for hip fracture repair in Ontario, Canada, between April 1, 2003 and March 31, 2011. MEASUREMENTS: The baseline characteristics of individuals who received general anesthesia (GA) and regional anesthesia (RA) were compared. Individuals who received GA were matched to similar individuals who received RA using propensity scores to control for confounding, and their outcomes compared, including 30-day mortality, intensive care unit (ICU) admissions, specific postoperative medical complications, and hospital length of stay (LOS). RESULTS: In the 6,135 matched pairs, there was no statistically significant difference in postoperative 30-day mortality (GA, 11.3%; RA, 10.8%, P = .44). There were no statistically significant differences in the rates of specific postoperative medical complications or LOS in the two anesthetic groups, but GA was associated with higher rates of ICU admissions (6.1% vs 4.2%, P < .001). CONCLUSION: For older adults with dementia undergoing hip fracture surgery, GA and RA are associated with similar rates of most perioperative adverse events. Further studies are required to determine the optimal methods of providing anesthesia and perioperative care for older adults with dementia undergoing surgical procedures.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| 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) | 0.001 | 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 source (direct Gemma or distilled Codex), 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".