364. IMPROVING PRE-OPERATIVE EMOTIONAL DISTRESS SHORTENS HOSPITALIZATION FOR ESOPHAGECTOMY
Bibliographic record
Abstract
Abstract Background Pre-operative emotional distress—characterized by anxiety, depression, and/or psychological stress—is commonly experienced by patients diagnosed with esophageal cancer. Previous studies have observed that emotional distress is associated with longer hospital length of stays (LOS) in various cancer populations, including esophageal cancer. However, the impact of changes in emotional distress during the pre-operative period on post-operative LOS remain unclear. This exploratory study aims to test whether improvements in pre-operative emotional distress influence post-esophagectomy LOS. Methods We conducted a retrospective analysis using data collected from a high volume North American tertiary care referral centre. Eligible participants completed the Functional Assessment of Cancer Therapy-Esophageal (FACT-E) at (1) diagnosis and (2) prior to esophagectomy. Emotional distress was measured using the FACT-E Emotional Well-Being (EWB) subscale. Changes in EWB scores between the two time points were categorized as ‘improved’ or ‘unimproved’ (i.e., stable or decreased). The Mann–Whitney U test was used to test the associations between LOS and the ‘improved’/‘unimproved’ EWB category. Results Of the 106 participants that completed the FACT-E at both time points and had an LOS related to esophagectomy, 67 (63%) were categorized as ‘improved’. Those in the ‘improved’ category experienced an average increase of 5.1 points in the EWB subscale score. The ‘improved’ group had an average LOS of 9.2 days compared to 10.4 days for the ‘unimproved’ group (p < 0.05). Conclusion Improvements in EWB score—used as a proxy for emotional distress—during the pre-operative period was associated with shorter postoperative LOS for esophageal cancer patients. The average difference was more than a full day. This suggests that emotional distress, if improved, can directly influence early outcomes and post-esophagectomy recovery. Future research should investigate the impact of pre-operative psychological assessments and interventions to better understand emotional distress as a modifiable risk factor for esophagectomy outcomes.
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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 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| 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) | 0.005 | 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".