General anesthesia versus regional anesthesia for the management of appendicitis in a county hospital in Northern Guatemala
Bibliographic record
Abstract
BACKGROUND: Both laparoscopic and open appendectomies are performed in low- and middle-income countries (LMIC). At a county hospital in Northern Guatemala, patients with appendicitis undergo an open appendectomy typically under regional anesthesia (RA); however, some patients require general anesthesia (GA). Characteristics of patients requiring GA were analyzed.METHODS: Data on 256 appendectomies performed at the Regional Hospital of San Benito Petén in Northern Guatemala were collected and dichotomized by anesthesia type GA (N.=46 [18%]) vs. RA (N.=210 [82%]). The characteristics between these two cohorts were analyzed.RESULTS: Most patients were young adults (age 23.3±14.7 years old, 56% male, 42.2% pediatric). Gross pathology demonstrated perforated, suppurative, and gangrenous appendicitis in 54% of patients. Male gender (70.0% vs. 30.0%), age less than 18 (23.1% vs. 11.6%), tachycardia on presentation, anorexia, and the Modified Alvarado Score (MASS) were significantly associated with GA. Male gender (OR [95% CI], 2.42 [1.08 to 5.42]), age less than 18 (4.21 [1.88 to 9.42]), and MASS (1.49 [1.13 to 1.96]) were independent predictors of patients necessitating GA.CONCLUSIONS: Male, young patients <18.0 years old, and those with a modified Alvarado score >6 should be considered for GA as they are likely to fail RA.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| 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) | 0.000 | 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 teacher head, 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".