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Record W2569596390 · doi:10.1055/s-0036-1582715

Predictors of Discharge Destination after Lumbar Spine Fusion Surgery

2016· article· en· W2569596390 on OpenAlexaff
Sultan Aldebeyan, Ahmed Aoude, Maryse Fortin, Anas Nooh, Peter Jarzem, Jean Ouellet, Michael H. Weber

Bibliographic record

VenueGlobal Spine Journal · 2016
Typearticle
Languageen
FieldMedicine
TopicSpine and Intervertebral Disc Pathology
Canadian institutionsMcGill University
Fundersnot available
KeywordsMedicineRehabilitationLumbarLogistic regressionPhysical therapySpinal fusionSurgeryComorbidityInternal medicine

Abstract

fetched live from OpenAlex

Introduction Lumbar spine fusion surgery is a common surgical procedure used to treat a variety of lumbar spine conditions. A great number of patients fail to go home after surgery and require transfer to a rehabilitation center. Many Patients requiring transfer to rehabilitation centers often have an extended hospital length of stay due to lack of beds at rehabilitation centers. Each extra day spent at the hospital costs the health system approximately $1000 USD. The aim of this study was to identify predictive factors for discharging patients to an inpatient rehabilitation center after undergoing lumbar spine fusion surgery. Methods We retrospectively identified a total of 15,092 patients undergoing lumbar spine fusion from 2011 to 2013 using the ACS-NSQIP database. Patients were dichotomized based on discharge destination to patients who were discharged home ( N = 12,339) and others who were discharged to a rehabilitation center ( N = 2753). Outcomes included patient demographics, comorbidities, and clinical characteristics. A multivariate logistic regression was used to identify whether outcomes studied were predictive factors for discharging patients to a rehabilitation center after lumbar fusion surgery. Results Majority of patients were discharged home after lumbar fusion surgery (81.76%) with only some discharged to a rehabilitation center (18.24%). Multivariate analysis identified age ≥40, female gender, comorbidities (diabetes, COPD, CHF, and obesity), minor and major complications, hospital length of stay (LOS), operative time ≥ 259 minutes, multilevel surgery, and return to the operation room as significant predictive factors of discharging patients to a rehabilitation center after lumbar fusion surgery. Conclusion The identified predictive factors can help the health system in developing an algorithm for early recognition of patients requiring postoperative admission to a rehabilitation center and possibly decreasing their hospital LOS. This can significantly decrease the hospital costs for such patients.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Full frame distilled prediction

Teacher imitation

Not 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.

metaresearch head score (Codex)0.000
metaresearch head score (Gemma)0.001
Version: codex-gemma-dda1882f352aValidation status: machine_predicted_unvalidated
Candidate categoriesInsufficient payload (model declined to judge)
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Observational · Consensus signal: Observational
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.245
Threshold uncertainty score1.000

Codex and Gemma teacher scores by category

CategoryCodexGemma
Metaresearch0.0000.001
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0000.000
Bibliometrics0.0000.000
Science and technology studies0.0000.000
Scholarly communication0.0000.000
Open science0.0000.000
Research integrity0.0000.000
Insufficient payload (model declined to judge)0.0010.000

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.

Opus teacher head0.014
GPT teacher head0.274
Teacher spread0.261 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one teacher head, not a consensus.

Study designObservational
Domainnot available
GenreEmpirical

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".

Quick stats

Citations2
Published2016
Admission routes1
Has abstractyes

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