A195 SURIVIVAL IN ACUTE ON CHRONIC LIVER FAILURE IN COMPENSATED CIRRHOSIS VS DECOMPENSATED CIRRHOSIS
Notice bibliographique
Résumé
Acute on chronic liver failure (ACLF) is a relatively newly coined term describing organ failure and acute decompensation in patients with chronic liver disease. Patients with ACLF have increased risk of short term mortality, as compared to patients with decompensated liver disease without ACLF. A recent study found as compared to patients who have had prior decompensation, patients presenting with new decompensation and ACLF developed a more severe form, with higher rates of mortality. Whether this finding is seen in other populations of patients with liver disease is unknown. To evaluate whether differences exist between patients with compensated cirrhosis who develop ACLF vs patients with decompensated cirrhosis who develop ACLF. Patients with cirrhosis admitted to The Ottawa Hospital (TOH) from July 2014 to July 2016 were retrospectively identified. They were identified by using ICD-10 diagnosis codes of: unspecified cirrhosis of liver, esophageal varices, ascites, hepatic failure, peritonitis, hepatorenal syndrome or postprocedural disorders of the digestive system to identify those with possible cirrhosis. A chart review was done and cirrhosis was confirmed by either liver biopsy, imaging characteristics or documented expert opinion. The charts of those with confirmed cirrhosis were then reviewed to determine whether they developed ACLF at or during admission. ACLF was defined using the European Association for the Study of Liver-Chronic Liver Failure (EASL-CLIF) ACLF definition. Organ failure was defined using the EASL-CLIF organ failures definition. Patients clinical characteristics and survival data up to 12 months from development of ACLF were collected. Groups were compared using Student’s t-test or a chi-squared test. Log-rank test was used to compare the survival of those with compensated cirrhosis who developed ACLF vs those with prior decompensated cirrhosis who developed ACLF. Out of 522 patients identified as having cirrhosis while admitted to TOH from 2014–2016, 94 were identified as having ACLF during their admission. 34 had compensated cirrhosis prior to development of ACLF, 60 had decompensated cirrhosis prior to development of ACLF. Patients with decompensated cirrhosis who developed ACLF were younger (mean age 54.78) than those with compensated cirrhosis who developed ACLF (mean age 59.71) (P 0.0342). The two groups were similar in etiology of cirrhosis, active alcohol use at admission, MELD-NA and MELD at admission, length of stay (LOS), and etiology of ACLF. There was no statistically significant difference in survival up to 12 months after development of ACLF between the two populations (Z = 0.071 P = 0.94). There was no statistically significant difference in survival between patients with compensated cirrhosis who developed ACLF vs patients with decompensated cirrhosis who developed ACLF. None
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,003 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,001 |
| Bibliométrie | 0,002 | 0,002 |
| Études des sciences et des technologies | 0,001 | 0,001 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,000 | 0,001 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,004 | 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 source (Gemma direct ou Codex distillé), 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 ».