The impact of acute perioperative myocardial infarction on clinical outcomes after total joint replacement
Why this work is in the frame
A frame that forgets how it found something cannot be audited. These are the routes that admitted this work.
Bibliographic record
Abstract
Background: Improvements in perioperative care have markedly decreased mortality after total joint replacement. Acute myocardial infarct (MI) is the most common clinically significant complication after total joint replacement (TJR) and the most common cause of 30-day mortality after TJR, which remains a concern especially in light of an older population with advanced comorbidities. In spite of this, little evidence exists in regard to its effect on TJR functional outcomes. Methods: To assess the potential impact, if any, of acute MI on the clinical outcomes of patients undergoing primary TJR, a matched cohort study of MI and non-MI patients was conducted to determine 1-year Oxford, Harris Hip and Knee Society score outcomes. Results: Of 12,739 primary TJR patients identified over a 9-year period, 0.9% (114; 95% CI, 0.75-1.1) experienced a perioperative MI. A greater proportion of MI than non-MI patients had ≥1 cardiac risk factor ( P =0.001) and an American Society for Anesthesiologist (ASA) 4 status ( P =0.037). Length of hospital stay was longer for MI cases (MI=11.5±9.8 vs. Non-MI=5.4±2.7, P <0.0001), with 70% requiring intensive care unit or cardiac care unit stays ( P <0.0001). One-year outcome scores were similar among groups ( P >0.05). One-year cardiac mortality rate was 6.1% compared to 0 non-MI deaths ( P <0.0001). Conclusions: While functional outcomes of MI after TJR are equivalent to non-MI, 1-year mortality remains high, and targeted cardiac screening and long-term monitoring for this patient population should be implemented.
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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 | 0.002 | 0.005 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.002 |
| 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 it