2: Anemia in pediatric intestinal failure: prevalence, etiology and predictors
Notice bibliographique
Résumé
Introduction: Anemia is an important health problem in children with intestinal failure (IF). It can contribute to neurodevelopmental delay and lower health related quality of life. Children with IF are at risk for iron deficiency anemia (IDA), anemia of inflammation (AI) and mixed IDA/AI. There is a paucity of data on the frequency of these types of anemias in children with IF and the contributions of the underlying etiologies is not well described. An improved understanding of the prevalence and causes of these anemias is needed to effectively treat and prevent anemia and its complications in children with IF. Methods: All children ages 6 months-18 years-old with intestinal failure, defined as the need for PN > 60 days due to intestinal disease or dysfunction, followed by the Group for Improvement of Intestinal Function and Treatment (GIFT) Program at SickKids Hospital between January 1, 2012 and December 31, 2021 were included. Children required a minimum of 1 complete blood count (CBC) and were excluded if they had intestinal transplant or had discontinued PN or follow-up before December 31, 2019. Data was retrieved longitudinally from electronic medical records. Anemia was defined by age-specific norms for hemoglobin; iron status was determined using soluble transferrin receptor (sTfR) and sTfR-ferritin index (sTfR-F). Frequencies of IDA (defined by anemia with ferritin <30 ug/L and elevated sTfR or sTfR-F>1.5), AI (anemia with ferritin > 100 ug/L and normal sTfR or sTfR-F <1) and mixed IDA/AI (anemia with ferritin 30-100 ug/L and elevated sTfR or sTfR-F>2) were determined. Period prevalence was calculated using the number of patients with anemia at any time during the 10-year study as the numerator and total number of patients as the denominator. Persistent anemia was defined as having anemia on > 2 occasions in patients with anemia and >1 CBC measurement. Statistical analyses included χ2 and test of proportions. Results: Fifty-four children met inclusion criteria. Median age at end of study was 4.8 ([IQR] 2.7-8.3) years, 52% male and median duration of follow up 3.4 (1.1-6.6) years. Short bowel syndrome (SBS) was present in 74%. The period prevalence of anemia was 76%; of 38 children with anemia and >1 annual CBC, 74% had persistent anemia. Of those with anemia, 11 (27%) had IDA, 27 (66%) AI and 7 (17%) mixed anemia; 7 children had >1 subtype of anemia. There was no difference in prevalence of anemia subtypes based on SBS status. Conclusions: A high 10-year period prevalence of anemia (76%) was found in this study. Only 27% had IDA, compared to 66% with AI. The relatively lower rate of IDA may be a result of routine iron supplementation in TPN. Comparison of this single center data to other Canadian centers (study ongoing) will provide an additional insight into the connection between methods of iron supplementation and frequency of anemia.
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 | 0,002 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,002 | 0,002 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| 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) | 0,003 | 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 ».