A252 LONG-TERM OUTCOMES IN INFLAMMATORY BOWEL DISEASE PATIENTS WITH PRIMARY SCLEROSING CHOLANGITIS: KINGSTON HEALTH SCIENCES CENTER LOCAL EXPERIENCE
Notice bibliographique
Résumé
Abstract Background IBD-PSC remains a poorly understood entity due to it’s low incidence and the heterogeneity found within this patient population. Patients with IBD-PSC have 0.3-2.8% lifetime risk of developing hepatocellular carcinoma, up to a 20% lifetime risk of developing Cholangiocarcinoma and a 20-30% lifetime risk of developing Colorectal Cancer (Fung et al. World J Gastroenterol 2019). To better understand long-term outcomes in this population, the use of large population level data can be useful but requires case validation. Purpose A large multicenter Canadian retrospective cohort study is ongoing with the goals of identifying an algorithm to identify IBD-PSC patients and compare long-term outcomes of IBD-PSC patients with a matched IBD cohort (Ricciuto et al, ongoing). This abstract describes the local data within Kingston Health Sciences Centre (KHSC) from this Canadian multi-center study and evaluates the use of ICD codes for the identification of IBD-PSC. Method This is a single centre retrospective cohort study of patients with IBD-PSC within KHSC from January 1993 - December 2021. Patients with potential IBD-PSC were initially identified locally using ICD codes for IBD and cholangitis. Charts were reviewed and IBD-PSC diagnosis was confirmed using pathology from liver biopsies and imaging. Those confirmed to have IBD-PSC then had data manually extracted from the local health administrative system. Outcomes of interest were divided into patient demographics, disease phenotype at diagnosis of IBD-PSC and therapies. Patients were followed until death, leaving the KHSC network or the end of the follow-up period. Result(s) Of the 862 patients identified using ICD codes, 16 (2%) were confirmed to have IBD-PSC after chart review. 50% of included patients had other autoimmune diseases. The median age of diagnosis of PSC was 34 years (IQR=22-43) while the median age of diagnosis of IBD was 22 (IQR=15-38). Large duct PSC was found in 88% of patients. Six patients had disease that was exclusively intra-hepatic. Two patients were found to have PSC with auto-immune hepatitis overlap. Mean ALP at diagnosis was 402 (IQR=208-506). Four patients developed cirrhosis, two of which experienced hepatic decompensation. Three patients underwent liver transplant. 81% of patients had ulcerative colitis. At the index lower endoscopy, 33% of patients had Mayo 3 colitis and 75% had involvement of the right colon. During follow up in our study, 81% of patients required systemic steroids and 33% required biologic therapy. Conclusion(s) ICD codes alone cannot reliably identify patients with IBD-PSC. The characteristics of the patients in our local experience are in keeping with existing literature. Completion of this multi-center study will allow for a greater sample size, a matched control group and a better understanding of the long-term impacts of this disease. Please acknowledge all funding agencies by checking the applicable boxes below None Disclosure of Interest None Declared
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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 | 0,000 |
| Bibliométrie | 0,001 | 0,002 |
| Études des sciences et des technologies | 0,002 | 0,001 |
| Communication savante | 0,001 | 0,000 |
| Science ouverte | 0,001 | 0,001 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,003 | 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 ».