472. ROUTINE PLACEMENT OF FEEDING TUBES SHOULD BE AVOIDED IN ESOPHAGEAL CANCER PATIENTS UNDERGOING SURGERY
Bibliographic record
Abstract
Abstract Perioperative nutritional optimization of patients undergoing esophagectomy for cancer is important as this population is prone to malnutrition associated with poor outcomes. Nutritional supplementation has been achieved via enteral nutrition through percutaneous feeding tubes such as gastrostomy tubes (G-tubes) and jejunostomy tubes (J-tubes). These are not benign and are associated with adverse events including infections, dislodgement, increased healthcare visits, among others. We aim to determine factors associated with adverse outcomes after feeding tube placement. Patients who underwent esophagectomy for carcinoma and had at least one feeding tube placed from November, 2017 to October, 2021 at a single institution were retrospectively reviewed. Subgroup analyses were performed testing for revelant chracteristics. Wilcoxon rank sum test was used to analyze non-parametric continuous data, and Chi-Square and Fisher's exact test for categorical variables. Univeriate and multivariate logistical regression analyses were conducted evaluating outcomes of interests. The primary outcome was the overall rate of tube-related complications. 136 patients were included with 201 feeding tubes placed. The rate of adverse events related to feeding tubes was 39%. Of these, 11% were wound infections, 16% required procedural intervention, 11% visited the Emergency Department due to feeding tube-related complications. Smoking history was a significant risk factor for complications compared to never-smokers (44% vs. 24%, p=0.011). Females had increased complications compared to males (58% vs. 35%, p=0.010). Comorbid patients (Charlson Comorbidity Index 5-6) were more likely to suffer from tube-related complications (OR=4.47, p=0.038). There were no significant differences seen in complications rates comparing G- and J-tubes (32% vs. 43%, p=0.11). There is significant morbidity related to feeding tubes. The risk profile of these tubes should be carefully discussed. Routine use of feeding tubes in esophagectomy patients should be avoided.
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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 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 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) | 0.003 | 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".