Routine perioperative practices and postoperative outcomes for elective lumbar laminectomies
Bibliographic record
Abstract
BACKGROUND: Routine investigations for asymptomatic patients undergoing low-risk surgery contribute little value to perioperative care, but these tests are still ordered in many centres. The primary purpose of this retrospective cohort study was to determine the prevalence of preoperative bloodwork for elective lumbar laminectomy and its association with intraoperative and postoperative complications. Secondary objectives were to determine the prevalence of intraoperative tranexamic acid administration, length of stay, and 30-day readmission. METHODS: Retrospective electronic chart reviews were conducted on all patients 18+ years old who underwent elective lumbar laminectomy by one orthopaedic spine surgeon between July 01, 2013 and June 30, 2017. All procedures were performed at the University Health Sciences Centre. RESULTS: Two hundred fifty-six patients underwent lumbar laminectomy at one or more levels during the study period. Among these patients, 89.5% underwent at least one preoperative blood test. The intraoperative complication rate was 2.34%. Intraoperative intravenous tranexamic acid was administered in <2% of surgeries; there were no postoperative blood transfusions. The 30-day hospital readmission rate was zero. CONCLUSIONS: Hospital policies should be re-evaluated to address the overuse of unnecessary preoperative investigations for elective lumbar laminectomies, which have low perioperative transfusion and complication rates.
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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 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| 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) | 0.001 | 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".