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Record W2810090445 · doi:10.1017/cjn.2018.225

P.123 Functional status in neurosurgery and out of hospital outcomes: insights from a 12 year, 2300 patient retrospective cohort study

2018· article· en· W2810090445 on OpenAlexvenueno aff
Alexander Winkler-Schwartz, JE Rydingsward, Kenneth B. Christopher

Bibliographic record

VenueCanadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques · 2018
Typearticle
Languageen
FieldMedicine
TopicManagement of metastatic bone disease
Canadian institutionsnot available
Fundersnot available
KeywordsMedicineQuartileNeurosurgeryLogistic regressionRetrospective cohort studyComorbidityCohortOdds ratioCohort studyMalignancyInternal medicineOddsEmergency medicineSurgeryConfidence interval

Abstract

fetched live from OpenAlex

Background: Limited information exists in neurosurgery regarding the association between functional status at hospital discharge and adverse events following discharge. Methods: A retrospective cohort study included all adults in one Boston teaching hospital who underwent neurosurgery between 2000-2012, survived hospitalization and had a Physical Therapist functional status assessment within 48-hours of discharge. 90-day post-discharge all-cause mortality was obtained from the US Social Security Administration Death Master File. Logistic regression analysis was used. Results: 2,369 patients were included, comprising 65% cranial and 35% spinal. Malignancy and trauma was 47% and 13%, respectively. 238 patients had independent functional status. 90-day mortality and readmission was 8.3% and 28%, respectively. Second, third and lowest quartile of functional status was associated with a 3.16 (95%CI 1.08-9.24), 6.00 (2.11-17.04) and 6.26 (2.16-18.16) respective increased odds of 90-day post-discharge mortality compared to patients with independent functional status, adjusting for age, gender, race, length of stay, presence of malignancy and Deyo-Charlson comorbidity. Good discrimination (AUC 0.82) and calibration (Hosmer-Lemeshow χ2 P = 0.23) were demonstrated. Adjusted odds of 90-day readmission in patients with the lowest quartile of functional status was 1.89 (1.28-2.80) higher than patients with independent functional status. Conclusions: Lower functional status at hospital discharge following neurosurgery is associated with increased post-discharge mortality and hospital readmission.

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 machine prediction

Teacher imitation

Not 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.

metaresearch head score (Codex)0.001
metaresearch head score (Gemma)0.003
Version: metacan-v3-hybrid-931329e0061cValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Observational · Consensus signal: Observational
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.008
Threshold uncertainty score0.016

Distilled classifier scores by category (both heads)

CategoryCodexGemma
Metaresearch0.0010.003
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0000.001
Bibliometrics0.0010.002
Science and technology studies0.0000.000
Scholarly communication0.0010.001
Open science0.0000.001
Research integrity0.0000.001
Insufficient payload (model declined to judge)0.0020.001

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 head0.029
GPT teacher head0.264
Teacher spread0.235 · 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 source (direct Gemma or distilled Codex), not a consensus.

The models applied no category: nothing in the taxonomy fit this work.
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

Citations0
Published2018
Admission routes1
Has abstractyes

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