Persistent inflammation-immunosuppression catabolism syndrome, a common manifestation of patients with enterocutaneous fistula in intensive care unit
Bibliographic record
Abstract
BACKGROUND: Persistent inflammation-immunosuppression catabolism syndrome (PICS) is a newly proposed concept that has replaced late multiple-organ failure and prolongs surgical intensive care unit (ICU) duration. Enterocutaneous fistula (ECF) is one of the most challenging complications in the practice of surgery. However, no studies have been performed connecting PICS with ECF. METHODS: A total of 130 ECF patients admitted to ICU between January 2011 and January 2012 were retrospectively studied. Two residents of our center collected data (including demographics, clinical manifestation, underlying disease, Acute Physiology and Chronic Health Evaluation II score, therapeutic schedules, laboratory test reports, and clinical outcomes) from electronic medical records for each patient. We further investigated the prevalence of PICS in patients with ECF and compared the demographics, disease severity, complications, clinical outcomes, and prognosis between PICS and non-PICS patients. RESULTS: The overall incidence of PICS in ECF was 43.1%. The mortality rates of non-PICS and PICS groups were 7.1% and 28.3%, respectively. Compared with the non-PICS group, the PICS group showed an increased age, a higher fistula output, but a lower body mass index and albumin level. However, the Acute Physiology and Chronic Health Evaluation II score did not differ between the two groups. During the whole treatment course, the PICS group showed a higher risk of developing pneumonia and catheter-related blood stream infection compared with the non-PICS group. Although the overall incidences of sepsis were similarly, the risk of developing sepsis after the first 7 days of admission was significantly higher in the PICS group (67.9% vs. 38.6%, p = 0.002). Moreover, the PICS group experienced longer stays in the ICU, higher hospital charges, and higher probabilities of mechanical ventilation compared with the non-PICS group. CONCLUSION: PICS is a common manifestation of patients with ECF. ECF provides an excellent clinical model to study PICS owing to the pathophysiologic characteristics of ECF itself. LEVEL OF EVIDENCE: Prognostic study, level III.
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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 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.000 | 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".