Incidence of clinically unsuspected pulmonary embolism in mechanically ventilated lung transplant recipients
Bibliographic record
Abstract
BACKGROUND: The incidence of pulmonary embolism (PE) in lung transplant recipients has not been well established. The purpose of this study was to describe the incidence of clinically unsuspected PE in a cohort of lung transplant recipients requiring mechanical ventilatory support. These patients underwent surgical lung biopsy (SLBx) for progressive deterioration in the absence of a specific diagnosis. METHODS: We retrospectively reviewed all SLBx pathology reports for mechanically ventilated lung transplant recipients with clinical deterioration, progressive radiographic abnormalities, or both at any time after transplantation. Our objective was to determine the incidence of clinically unsuspected PE in this patient population during an 11-year period. RESULTS: Clinically unsuspected PE was identified in 8 (19.5%) of 41 mechanically ventilated lung transplant recipients after a median of 20 days (interquartile range: 16.3, 148.8 days) after transplantation. There was a tendency for clinically unsuspected PE to occur in the early postoperative period, with the majority of events (75%) occurring within 14 weeks of transplantation. Pulmonary infarction occurred in 37.5% of cases and occurred uniformly during the postoperative period. The finding of pulmonary emboli on SLBx lead to confirmatory investigations in five (62.5%) of eight patients and changed management in seven (87.5%) of eight patients. CONCLUSIONS: A high index of suspicion and reliance on ancillary diagnostic testing may be insufficient to establish the diagnosis of postoperative pulmonary emboli. PE is an underappreciated complication contributing to respiratory failure in the early postoperative period in lung transplant recipients, warranting identification of putative risk factors and consideration for prophylaxis.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.005 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".