Avoidable Emergency Department Utilization Within 6 Months Following Elective Thoracolumbar Spine Surgery for Degenerative Pathologies
Bibliographic record
Abstract
Study Design: Retrospective study. Objective: To identify prevalence of, reasons for, and predictors of emergency department (ED) utilization 6 months following elective thoracolumbar spine surgery. Methods: A retrospective review of a patient database was conducted (N = 577). Visits were divided by orthopedic spinal surgeons into (1) avoidable ED visit, (2) appropriate/no visit, and (3) unrelated visit. Measures: Demographics, pain scores, patient characteristics, and surgical factors. Results: A total of 14.38% of patients made an ED visit the majority for avoidable reasons (11.43%). Avoidable ED visits were predominately attributed to pain (45.5%) and physiology-related issues (50.0%). Significant differences in the Numerical Rating Scale–leg pain (NRS-L); U = 13 931, P = .031) were found. Patients with avoidable visits had higher leg pain prior to surgery than those without an avoidable visit. Marital status was also statistically significant, χ 2 (2, N = 535) = 8.189, P = .017. Patients were more likely to make an avoidable postoperative ED visit if they were either single or divorced/separated compared to patients who were married. A multivariate logistic regression model including NRS-L and marital status was statistically significant, χ 2 (3) = 10.14, P = .017; however only explained 3.7% of the variance. Conclusion: A large percentage of elective thoracolumbar surgery patients returned to the ED within 6 months for avoidable reasons. Patients likely to make avoidable visits could not be identified prior to surgery in a clinically meaningful way. Reasons for patients returning to the ED for avoidable reasons focused on pain management and minor physiological symptoms. Enhanced presurgical education may manage postsurgical expectations helping to prevent avoidable ED visits.
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How this classification was reachedexpand
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 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 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 itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, 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".