High complication rate among patients undergoing appendectomy in Ontario: a population-based retrospective cohort study
Bibliographic record
Abstract
BACKGROUND: Appendectomy is a common emergency procedure. The risks have been reported in previous studies but often are limited to inpatient complications. The purpose of this study was to describe inpatient and outpatient rates of complications associated with appendectomy in a contemporary population-based cohort and explore factors associated with these complications. METHODS: We conducted a retrospective study using linked data for Ontario within Institute for Clinical Evaluative Sciences databases. Patients who underwent emergent appendectomy between 2009 and 2014 were included. The primary outcome was a complication (death, readmission, emergency department visit, lengthy [> 7 d] hospital stay, percutaneous abscess drainage, reoperation or 1 of the predefined complication codes) occurring within 30 days of surgery. We used modified Poisson regression to identify predictors of complications. RESULTS: A total of 50 369 patients underwent emergent appendectomy over the study period, of whom 16 953 (33.7%) had a perforated appendix. Overall, 14 451 patients (28.7%) (8428 [25.2%] in the nonperforated group and 6023 [35.5%] in the perforated group) had at least 1 complication. The most common complication was an emergency department visit (7942 patients [15.8%]), followed by surgical site infection (4792 [9.5%]). Increasing age, female sex, rural residence, perforation status, daytime surgery and open surgical technique were associated with increased risk of complications. CONCLUSION: We found a higher rate of complications after appendectomy than previously reported. The most common complication was presentation to the emergency department. Our definition of complications is more inclusive than in previous studies and provides a deeper understanding of complications after appendectomy.
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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 | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.001 |
| 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".