Bibliographic record
Abstract
Introduction: In the intensive care unit (ICU), thrombocytopenia (TCP) is the most frequently encountered coagulation abnormality. Drugs are suspected when obvious causes have been excluded. It is estimated that 10-25% of cases in ICU patients may be drug-induced. Hypothesis: The risk of TCP associated with drugs classes commonly used in the ICU is low. Methods: Data concerning patients admitted for more than 48 hours between 1997 and 2007 was extracted from a research-purpose database. Patients with TCP within the first 72 hours of admission and with conditions strongly associated with TCP were excluded. Cases were defined as patients with at least one episode of TCP (<100 x 109/L) during their ICU stay. We defined exposure to medications associated with TCP as at least one dose in the 7 days prior to TCP in cases and as at least one dose prescribed in the first 7 days of admission in controls. We also controlled for risk factors including APACHE II score. Drug exposures and risk factors were compared using conditional logistic regression. Drug exposures and risk factors with a p value below 0.2 in the univariate analysis were included in the multivariate analysis. Results: A total of 15047 patients were admitted during the study period. After excluding patients with TCP within 72 hours of admission, there were 12275 patients remaining from which 422 patients with an episode of thrombocytopenia were identified. A total of 200 cases were identified after excluding for conditions highly associated with TCP. Each case was matched according to sex, age category, year of admission and admission unit with one control from the cohort. In univariate analysis, the only drug classes associated with thrombocytopenia were quinolones and to a lesser extent beta-lactames, aminoglycosides and antifungals. In the multivariate analysis, exposure to quinolones was the only drug class with an increased risk of thrombocytopenia (OR 1.72 95%CI 0.96-3.10;p=0.07) but it did not reach statistical significance. Conclusions: This study confirms that clinicians’ should first consider other causes of TCP. Drug-induced TCP is probably a rare complication in ICU patients. The association between quinolones and TCP warrants further investigation.
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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 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.002 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.656 | 0.501 |
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".