Pediatric Investigators Collaborative Network on Infections in Canada (PICNIC) Study of Respiratory Syncytial Virus-Associated Deaths in Pediatric Patients in Canada: A Retrospective Review From 2003 to 2013
Bibliographic record
Abstract
Background. Respiratory syncytial virus (RSV) is a major cause of pneumonia and the major cause of bronchiolitis in infancy. Mortality rates in previously healthy infants with RSV pneumonia and bronchiolitis are less than 0.5%, but rates are higher in severely immunocompromised patients. Although mortality is rare, such cases do occur. To this end, data are lacking for the risk factors associated with mortality from RSV infection among children in Canada. The objective of this study was to determine the number of RSV-related deaths and the factors associated with these deaths among children hospitalized with RSV infection in Canadian pediatric centers. Methods. Retrospective review of all RSV-associated deaths at centers affiliated with the Pediatric Investigators Collaborative Network on Infections in Canada over the period 2003–2013, inclusive. Cases were identified using similar International Classification of Diseases codes to capture all deaths where a diagnosis of RSV infection was also present. Results. Overall, 8 centers reported 66 RSV-associated deaths. Respiratory syncytial virus was regarded as primarily responsible for deaths in 27 (41%) of cases. The median age of children who died was 11 months (range, <1 month to 16 years). Twenty-five patients (38%) were male. Thirteen deaths (20%) occurred among patients with no known risk factors for severe RSV. Thirty-eight deaths (58%) were among patients who had underlying chronic medical conditions without known immune deficiency, whereas 14 (21%) occurred among immunocompromised hosts. Community-acquired infections accounted for 43 deaths (65%). Fifty-five subjects (83%) were admitted to an intensive care unit and received mechanical ventilation. Palivizumab use was reported in 4 (6.1%) and 3 (4.6%) subjects for prophylaxis and treatment, respectively. Ribavirin use for treatment was reported in 8 (12%) subjects. Conclusion. Respiratory syncytial virus-associated deaths were predominantly associated with chronic medical conditions and immunocompromised states among infants. However, 1 of every 5 deaths occurred among infants with no known risk factors for severe RSV. Deaths associated with nosocomially acquired infections were observed. Further study of the factors (e.g. immunogenetic) associated with deaths is warranted. Disclosures. J. Papenburg, Becton, Dickenson and Co.: Investigator, Research grant. RPS Diagnostics: Board Member, Consulting fee AbbVie Inc: Board Member, Consulting fee; J. M. Langley, GSK: Investigator, Research support
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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 | 0.004 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.002 |
| Bibliometrics | 0.006 | 0.016 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| 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".