Preoperative warming and undesired surgical and anesthesia outcomes in pediatric spinal surgery—a retrospective cohort study
Bibliographic record
Abstract
BACKGROUND: Underbody forced air warming is a method commonly used for intraoperative temperature maintenance in children. We previously reported that preoperative forced air warming of children undergoing spinal surgery substantially reduces the incidence and duration of intraoperative hypothermia (<36°C). OBJECTIVE: The aim of this study was to evaluate the effects of preoperative warming before spinal deformity surgery on surgical site infection rate, length of hospitalization, and bleeding (estimated blood loss and incidence of cell salvaged and/or allogeneic packed red blood cell transfusions). METHODS: Demographic, anesthetic, and surgical data of all patients who underwent spinal deformity surgery between December 2009 and December 2012 were obtained by retrospective chart review. Temperature data were abstracted from an existing repository; the incidence and duration of hypothermic episodes were identified. For each outcome, logistic regression models and propensity score analysis were used to estimate the effect of prewarming, adjusted for potential confounders. The issue of missing data was handled by a multiple imputation method. Data from 334 procedures were used in modeling and propensity score stratification. RESULTS: Adjusted odds ratios for the effects of prewarming were 0.47 (95% CI 0.15-1.49) for surgical site infections; 0.89 (95% CI 0.55-1.41) for cell salvaged blood transfusion; 0.43 (95% CI 0.22-0.83) for allogeneic packed red blood cell transfusion; and 1.24 (95% CI 0.77-1.99) for a length of hospitalization >6 days. Adjusted mean decrease in estimated blood loss for prewarming was 72 (95% CI -29 to 173) ml. CONCLUSION: In this study, prewarming was associated with a reduction in allogeneic packed red blood cell transfusion. However, no causal relationship between prewarming and reduced allogeneic blood transfusion should be assumed. Prewarming was not associated with reductions in estimated blood loss, length of hospitalization, or the incidence of surgical site infection.
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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 | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| 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".