Elective, Major Noncardiac Surgery on the Weekend
Bibliographic record
Abstract
IMPORTANCE: Previous research has demonstrated that patients undergoing elective surgery on the weekend had an adjusted risk of 30-day mortality that was significantly higher than that of patients operated upon during the week. The generalizability of this association and effect size is unknown. OBJECTIVES: The aim of this study was to investigate the generalizability of the association between elective weekend surgery and increased 30-day postoperative mortality. RESEARCH DESIGN: A retrospective, propensity score-matched cohort analysis of linked population-based health administrative data was carried out. SUBJECTS: Individuals undergoing elective, intermediate, intermediate-risk to high-risk all describe the noncardiac surgery exposure at all acute care hospitals in Ontario, Canada, between 2002 and 2012 were included. EXPOSURE: Elective surgery was performed on the weekends. MEASURES: All-cause mortality was measured within 30 days of the operation. RESULTS: A total of 333,344 patients were studied, of whom 2826 died within 30 days of surgery (overall crude mortality rate 8.5 deaths per 1000). Weekend elective surgery was performed on 2520 patients, of whom 2518 were successfully propensity score matched to weekday surgical patients. Undergoing elective surgery on the weekend was associated with a 1.96 times higher odds of 30-day mortality than weekday surgery (95% confidence interval, 1.36-2.84) in a propensity-matched analysis. This significant increase in the odds of postoperative mortality was confirmed using a multivariable logistic regression analysis (odds ratio 1.51; 95% confidence interval, 1.19-1.92). CONCLUSIONS: Similar to previous studies in distinct health care systems, patients in Ontario undergoing elective surgery on the weekend experienced an increased risk of 30-day postoperative mortality. Mechanisms underlying this effect require further study.
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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 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.003 | 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".