A 10 YEAR REVIEW OF PEDIATRIC INTESTINAL FAILURE PATIENTS IN NORTHERN ALBERTA
Bibliographic record
Abstract
Objectives: Having intestinal transplantation at our centre, we aim to determine prognostic factors for children with intestinal failure (IF) in our region. Methods: We conducted a retrospective review of children treated from 94-04 who met our criteria for IF - dependence on parenteral nutrition (PN) for more than 100 days or diagnosed with IF who died prior to 30 days of PN. ANOVA, Kaplan-Meier method, and Fisher's test were used. Result: 44 children were treated for IF at our centre (1994-2004). 11 infants died before the first month of life - early death IF (EDIF). 33 children required PN for more than 100 days - long-term PN IF (LTIF). 22 had necrotizing enterocolitis, followed by 8 gastroschisis. EDIF patients had lower birth weight (p = 0.013), gestational age (p = 0.025) and gut length (p = 0.000) compared to the LTIF patients. Main cause of death in EDIF patients were withdrawal treatment (n = 8). Liver failure (n = 5) and sepsis (n = 4) were causes of death in LTIF. LTIF also had an increase in number of septic episodes prior to death. Of the 33 LTIF, 12 died, 17 were weaned from PN, 3 were on PN at the time of the study and 1 was transferred. There were no significant differences in demographics between the deceased and adapted LTIF. Of the 29 LTIF children with known outcome, 25 were diagnosed with short bowel syndrome (SBS). 11 patients died, 14 patients were survived and weaned from PN. LTIF with gut length <40 cm had less than 20% cummulative survival vesus >70% in those with gut length >40 cm. From 150 days onward, a rising trend for TBIL, AST/ALT were seen in those deceased, while a plateau or resolving trend for those adapted. The deceased had a significantly greater proportion of patients with an AST >100 U/l, ALT >150 U/l, TBIL >150 umol/l, ALB <30 g/l, and Platelet <100 000. only 2 deceased LTIF patients reached below 40 kcal/kg of PN use. Conclusions: Infants who survived more than 100 days, intestinal length <40 cms, rising TBIL more than 150 umol/l with rising transaminases, recurrent sepsis and needing >40 kcal/kg of PN were poor prognostic factors.
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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 | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.004 | 0.009 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 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".