Risk of Hip Arthroplasty After Open Reduction Internal Fixation of a Fracture of the Acetabulum: A Matched Cohort Study
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
OBJECTIVES: To determine what proportion of operatively treated acetabular fracture patients proceeded to total hip arthroplasty (THA), over what time period, and quantify the influence of patient, provider, and surgical factors on rates of THA. DESIGN: Retrospective matched cohort prognostic study using administrative data. SETTING: This study used the large population database of Ontario (population 13,125,000 in 2010), Canada. PARTICIPANTS: Patients who underwent open reduction internal fixation (ORIF) of an acetabulum fracture between 1996 and 2010 in the province of Ontario were identified from administrative health databases. METHOD: Each patient was matched to 4 individuals from the general population according to age, sex, income, and urban/rural residence. The rates of THA at 2, 5, and 10 years were compared using time-to-event analysis. The influence of patient, provider, and surgical factors on the risk of eventual THA was examined using a Cox model. INTERVENTION: The primary intervention was ORIF of the acetabulum. MAIN OUTCOME MEASUREMENT: The primary outcome measurement was THA. RESULTS: A total of 1725 eligible patients were identified and were matched to 6900 controls. Among cases, there was a 13.9% (N = 240) rate of hip arthroplasty after a median of 6.25 (interquartile range 3.5-10.1) years, compared with 0.6% (N = 38) among matched controls (relative risk = 25.26). The greatest difference in risk of eventually undergoing a THA was in the first 10 years, after which time the risk in the group that had undergone ORIF acetabulum trended down toward that of the control group. Among surgical patients, risk factors for eventual hip arthroplasty included older age [hazard ratio (HR) 1.035 (1.027, 1.044); P < 0.0001]; female sex [HR 1.65 (1.257, 2.165); P = 0.0003]. Higher surgeon volume revealed a 2.6% decreased risk of arthroplasty for each acetabulum ORIF performed above 10 per year [HR 0.974 (0.960, 0.989); P = 0.0007]. CONCLUSION: Patients who underwent acetabulum fracture ORIF had a 25 times higher prevalence of hip arthroplasty compared with matched controls. THA rate was greater in women, older patients, and patients whom had ORIF performed by low-volume surgeons. LEVEL OF EVIDENCE: Prognostic Level II. See Instructions for Authors for a complete description of levels of evidence.
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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 | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| 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