MP64-07 REVISITING RISK FACTORS FOR FEBRILE URINARY TRACT INFECTION USING A LARGE PRENATAL HYDRONEPHROSIS DATASET
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Résumé
You have accessJournal of UrologyPediatrics: Urinary Tract Infection & Vesicoureteral Reflux (MP64)1 Apr 2019MP64-07 REVISITING RISK FACTORS FOR FEBRILE URINARY TRACT INFECTION USING A LARGE PRENATAL HYDRONEPHROSIS DATASET Luis H. Braga*, Smruthi Ramesh, Melissa McGrath, Armando J. Lorenzo, C.D. Anthony Herndon, and Forough Farrokhyar Luis H. Braga*Luis H. Braga* More articles by this author , Smruthi RameshSmruthi Ramesh More articles by this author , Melissa McGrathMelissa McGrath More articles by this author , Armando J. LorenzoArmando J. Lorenzo More articles by this author , C.D. Anthony HerndonC.D. Anthony Herndon More articles by this author , and Forough FarrokhyarForough Farrokhyar More articles by this author View All Author Informationhttps://doi.org/10.1097/01.JU.0000556899.87214.a4AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVES: Risk factors for febrile UTI (fUTI) in infants with prenatal hydronephrosis (HN), such as female gender, uncircumcised status, high grade HN and non-refluxing primary megaureter (NRPM) have been consistently documented in several small sample size series, however the same cannot be said regarding continuous antibiotic prophylaxis (CAP). Herein, we revisit this clinically important outcome using a large single center database to confirm or refute these previous findings. METHODS: Since 2009, we have prospectively followed 876 consecutive prenatal HN infants <12 months of age with the following conditions: UPJO-like, non-refluxing primary megaureter (NRPM) and VUR. Patients with <6months F/U were excluded. A priori collected variables included: HN SFU grade (low-I/II vs. high-III/IV), HN etiology, CAP, gender and circumcision status. Primary outcome was catheter specimen fUTI. Time to event curves (Hazard ratio-HR) were analyzed by Cox proportional regression to adjust for confounders. Analyses were done with and without VUR patients. RESULTS: Of 848 included patients, 632 (75%) were male and 36% were circumcised. 73 (9%) had a fUTI at a median age of 6 months (IQR 9). Mean follow-up was 30 months (6-120). High grade HN was seen in 467 (55%) infants and CAP prescribed for 450 (53%). VUR (68% grades IV-V) was detected in 168/572 (29%) patients who had a VCUG. Upon univariate analysis, a significantly higher fUTI rate was seen in females, uncircumcised males, patients with NRPM and high grade HN (Table 1). In the Cox proportional regression model, NRPM (HR=4.8, p<0.01), VUR (HR=7.0, p<0.01), uncircumcised males (HR=2.3, p=0.03), females (HR=2.5, p=0.02), and lack of CAP (HR=3.7, p<0.01), were significantly associated with fUTI (Table 2). HN grade was not found to be associated with fUTI. KM curves for fUTI risk factors are shown in Fig. 1. CONCLUSIONS: This study validates previous findings, confirming NRPM, VUR, uncircumcised status and female gender as important risk factors for fUTI. According to our large dataset analysis, CAP significantly reduced fUTIs and should be offered to these high-risk HN patients. Source of Funding: none Hamilton, ON; Hamilton, Canada; Toronto, Canada; Richmond, VA; Hamilton, Canada© 2019 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 201Issue Supplement 4April 2019Page: e943-e944 Advertisement Copyright & Permissions© 2019 by American Urological Association Education and Research, Inc.MetricsAuthor Information Luis H. Braga* More articles by this author Smruthi Ramesh More articles by this author Melissa McGrath More articles by this author Armando J. Lorenzo More articles by this author C.D. Anthony Herndon More articles by this author Forough Farrokhyar More articles by this author Expand All Advertisement PDF downloadLoading ...
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 | 0,016 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,002 |
| Bibliométrie | 0,002 | 0,002 |
| Études des sciences et des technologies | 0,001 | 0,000 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,001 | 0,002 |
| Intégrité de la recherche | 0,001 | 0,002 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,022 | 0,013 |
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 ».