The use of functional capacity to predict postoperative outcomes in subjects undergoing colorectal resection
Bibliographic record
Abstract
Introduction: There is increasing evidence to suggest that functional capacity assessment can identify patients at high risk for major surgery, however previous studies have used heterogeneous patient populations. We sought to investigate the effect of poor functional capacity on the incidence of postoperative complications in a population of subjects undergoing elective colorectal surgery. Methods: A retrospective cohort study of adult subjects undergoing elective colorectal resection at a single university-affiliated institution from 2005 to 2011 who were participants in three clinical trials was performed. The main exposure variable was poor functional capacity as measured by cardiopulmonary exercise testing (CPET) or by the distance walked in six-minutes (6MWT). The main outcome variable was complications that occurred within 30 days of the index operation and length of stay. Receiver-operating characteristics curves identified threshold for increased perioperative risk. Multiple regression models estimated the effect of exposure on the outcome by adjusting for confounders. Results: A total of 296 were included in the overall subject cohort. The 6MWT was available in all subjects, and CPET was available in 114 subjects. The overall incidence of postoperative complications was 42% (126/296). The threshold for increased perioperative risk was found to be a peak oxygen consumption (VO2) < 72% of predicted,and a 6MWT < 392 meters. After adjusting for confounders, the odds of suffering a major complication was 7.66 times (95% confidence interval 1.57–37.44) higher in subjects with peak VO2 < 72% of predicted compared to those with peak VO2 ≥ 72% of predicted. The odds of suffering a cardiopulmonary complication (OR 4.75, 95% CI1.46–15.44) or minor complications (OR 1.87, 95% CI 1.02 – 3.46) was significantly higher in subjects with 6MWT < 392 meters. However, major complications were not associated with 6MWT < 392 meters (OR 1.10, 95% CI 0.42–2.99), after adjusting for confounders. Conclusions: Poor functional capacity is associated with increased perioperative risk in subjects undergoing elective colorectal surgery. Functional capacity assessment can be performed using CPET or the 6MWT.
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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 | 0.002 | 0.006 |
| 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 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| 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".