P0293 FINAL EVALUATION OF A LOOKBACK PROCEDURE TO IDENTIFY HCV INFECTION IN THE TRANSFUSED NICU POPULATION
Notice bibliographique
Résumé
Introduction: Transfusions of blood and blood products were frequently administered to infants admitted to the NICU nursery in the period between 1978–1989 before the identification of the Hepatitis C virus. This lookback study encompasses three distinct time periods between Jan 1978 and Oct 1985 (pre-HIV screening), Nov 1985–Apr 1990 (pre 1st generation HCV testing) and May 1990–Mar 1992 (pre 2nd generation HCV testing) –Periods 1,2 and 3 respectively. Specific aims were to: 1. Determine the incidence and natural history of HCV infection in infants transfused between Jan 1978 and Mar1992. 2. Assess parental awareness of transfusion 3. Examine the efficacy and feasibility of a lookback procedure using various methods of contact (medical records address, provincial health insurance database, provincial archival look-back, provincial laboratory database) Methods: Records from 21,248 (96.9%) of the 21,928 admissions to the two Regional NICU’s in Edmonton were reviewed for transfusions. A package including a requisition for HCV Ab and PCR testing and a questionnaire regarding knowledge of transfusion and its associated risks was mailed to identified transfused infants’ caregivers using the methods of contact above. Results: 7590 (36%) of the infants were transfused. Results are now expressed according to Periods 1, 2 and 3. Transfused neonates decreased over time from 42.4% to 29.9% to 19.4%. The transfused group had significantly higher in-hospital mortality proportions than the non-transfused group (14.4%, 16.4%, 17.2% vs 3.6%, 2.5%, 5%). Awareness of transfusion was 46.3%, 51.2% and 60.1%. Successful testing responses were 31.5%, 48.8% and 45.2%. Of children tested for HCV Ab, 17 (1.5%), 12 (1.5%) and 1 (0.4%) children were positive and 3 subjects in each of periods 1 & 2 were HCV-indeterminate. The rate of Hepatitis C PCR positivity in the whole group positive for HCV antibody was 67%. Crude per donor risks of HCV in the three periods were 0.0027, 0.0028 and 0.0005 respectively. Conclusion: Transfusions decreased over time in both NICU’s, but transfused infants had significantly higher in-hospital mortality than non-transfused infants. Parental awareness of transfusion increased over time, as did successful testing for HCV Ab. The rate of HCV infection in the NICU’s was 1.5% for the period prior to the introduction of 1st generation HCV Ab testing, and decreased thereafter, as did crude per donor HCV risk. The rate of PCR positivity in our group of HCV positive patients was 67%. We acknowledge the support of CIHR, MRC, Canadian Blood Services, the Canadian Red Cross Society and the Children’s Health Foundation of Northern Alberta.
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Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».