Analysis of Patient Presentation to the ED Within 90-days of Infra-inguinal Bypass
Bibliographic record
Abstract
BACKGROUND: Postoperative re-presentation to healthcare causes distress to patients and increases resource utilization. However, patients that re-present but do not require readmission are often not factored in traditional quality improvement datasets. This study aimed to identify risk factors for emergency department (ED) visits without readmission following infra-inguinal bypass. METHODS: A retrospective cohort study was conducted, reviewing infra-inguinal bypass performed at QEII Health Sciences Center between January 1, 2020, and December 31, 2021, in Halifax, Nova Scotia. Data from the Vascular Quality Initiative database was merged with provincial ED records to identify patients presenting to the ED within 90 days postoperatively. Descriptive statistics and multivariable logistic regression were used to identify predictors of ED visits without readmission. RESULTS: Of 232 infra-inguinal bypasses performed, 29% re-presented to the ED within 90 days. Eighty-four percent of ED visits did not result in readmission. Indications for re-presentation included noninfectious wound complications (33.1%), surgical site infections (19.7%), and nonwound complications (18.3%). Complaints unrelated to the primary procedure accounted for 26.1% of all ED visits. Discharge on dual antiplatelet therapy (odds ratio [OR] 3.55, 95% confidence interval [CI] 1.30-9.68) or anticoagulants (OR 2.58, 95% CI 1.04-6.37) was associated with increased odds of re-presentation. Medication-controlled diabetes (OR 0.25, 95% CI 0.10-0.65) and urgent repair (OR 0.15, 95% CI 0.04-0.62) were associated with decreased odds of re-presentation. CONCLUSION: A considerable proportion of patients re-present to the ED without readmission after infra-inguinal bypass, most frequently for wound complications. Targeted quality improvement initiatives addressing this group could reduce unnecessary healthcare use and improve outcomes.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
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 | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.002 |
| 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) | 0.000 | 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".