OC-084 The targeted use of Taurolock® to reduce central venous catheter sepsis in a home parenteral nutrition cohort
Bibliographic record
Abstract
Introduction Taurolock® (Bio-Implant HealthCare, Winsen, Germany) is an anti-microbial agent (taurolidine) with anticoagulant properties (citrate). There is evidence that Taurolock® is beneficial in reducing catheter-related blood stream infections (CRBSI) in haemodialysis patients, but there are fewer data regarding benefit in home parenteral nutrition (HPN) patients.12 At St Mark9s Intestinal Failure Unit Taurolock® is prescribed for patients with greater than three CRBSI in a 12-month period. The primary aim was to determine the incidence of CRBSI prior and subsequent to Taurolock® use. The secondary aim was to establish cost benefit from Taurolock® prescription. Methods Retrospective audit using St Mark9s Intestinal Failure (IF) Database. ::::CRBSI and Taurolock® prescription recorded on IF database. CRBSI defined as positive central venous catheter blood cultures with fever±rigors. Simple cost analysis calculated at £8340 per hospital treatment for CRBSI (10 day in-patient admission) and Taurolock costing £11 per day. Results All 16 patients (male 56.3%, mean age 44.8 years (range 23–73)) prescribed Taurolock® were selected. In the pre-treatment group mean duration from first CRBSI episode to Taurolock® prescription was 602±317 days. This pre-treatment group had a mean 9.8±6.5 CRBSI rate per 1000 catheter days. The treatment group (mean duration 557±269 days) had a mean 3.3±3.4 CVC related sepsis rate per 1000 catheter days. There was a significant difference (p<0.001) in CRBSI rate prior and subsequent to Taurolock® prescription. Treating CRSBI for 1 year in these 16 patients pre-Taurolock® cost approximately £367 000 (440 in-patient days and antibiotic costs). Approximate treatment group costs were £228 240 (£164 000 hospital costs for treating CRBSI and £64 240 for Taurolock treatment). One year cost savings of Taurolock® prescription was £138 760. Conclusion Taurolock® significantly decreases CRBSI rate in HPN patients. These results are in keeping with a Canadian group that managed to decrease CRBSI following treatment in seven patients. (2) Taurolock® prescription generates considerable cost savings in this cohort of patients.
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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 | 0.001 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.003 | 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".