Fluid balance following laparotomy for hollow viscus perforation: A study of morbidity and mortality
Bibliographic record
Abstract
Background: In critically unwell patients requiring emergency abdominal surgery, the relationship between the volume of intravenous fluid given, the subsequent fluid balance and morbidity or mortality is poorly delineated. This study aimed to elucidate this relationship. Materials and methods: Retrospective analysis of data from a single medical center. Patients presenting emergently to hospital requiring abdominal surgery for perforation of a hollow viscus with subsequent intensive care unit admission were identified. Clinicopathological, surgical and postoperative data were collected. The volume of intravenous fluid therapy was recorded and fluid balance was calculated from hospital arrival to the end of postoperative day (PoD) 5. Univariate and multivariate logistic regression was used to identify variables associated with patient morbidity or mortality. Results: Overall 51 patients met inclusion criteria. On univariate analysis, low serum sodium was associated with an increased incidence of postoperative complications. Postoperative mortality was associated with high postoperative serum sodium and low albumin, increasing age, pre-existing hypertension and ischaemic heart disease. In patients who died, a positive fluid balance was found on PoD 1-4 whilst in patients who survived, their fluid balance was negative. On multivariate analysis, positive postoperative fluid balance and increasing age were independently associated with an increased risk of death. Conclusions: Larger volumes of postoperative intravenous fluid and greater positive postoperative fluid balance are associated an increase in postoperative mortality but not morbidity following emergency abdominal surgery for perforation of a hollow viscus.
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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 | 0.001 | 0.000 |
| Open science | 0.000 | 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".