Pediatric Venous Thromboembolism: Redefining Epidemiology.
Bibliographic record
Abstract
Abstract Abstract 5055 Introduction Pediatric venous thromboembolism (VTE) is a multifactorial disease most commonly seen in children with complex medical conditions. The data regarding associated conditions in children is sparse. The most comprehensive source regarding these associations is derived from the Canadian registry of 137 children with VTE collected from 1990-1992. Objective To refine the spectrum of pediatric VTE associated illnesses, utilizing a large, comprehensive claims database. Methods The Healthcare Cost and Utilization Project (HCUP) Kids' Inpatient Database (KID) 2006 was utilized to identify children <18 years old with in-hospital VTE. These children were identified by the presence of at least one of the following ICD-9-CM diagnosis or procedure codes: 325, 452, 453(.0, .2-.42), 453 (.8-.9), 415 (.0-.11), 38 (.05, .07, .09), or 99.10. The remaining diagnostic ICD-9-CM codes were then utilized to assign a preliminary Complex Chronic Condition (CCC) category for each patient, using previously defined criteria. This categorization was further refined by a manual translation of the diagnostic codes by one of the investigators (BAS or BAK). The incidence of in-hospital VTE by geographic region, hospital type, age, gender, ethnicity, and median household income was estimated. Results 4,731 children met the inclusion criteria (1.76/1,000 discharges). The major underlying illnesses were cardiovascular (18%), malignancy (17%), neuromuscular disease (11%), gastrointestinal (8%), hematology/immunology (7%), and metabolic disease (6%). Trauma and surgical interventions were present in 5 % while 5% of VTE was idiopathic. Renal, respiratory, and autoimmune diseases were less commonly associated with VTE (<5%). Interestingly, the incidence of VTE was highest in the Midwest (2.12/1,000 discharges) and lowest in the South (1.60/1,000 discharges). As seen in previous studies, VTE was more commonly seen in infants and adolescents. There was a slight predominance of males with VTE (1.22:1). 4.2% of the VTE were associated with in-hospital death. Conclusion Pediatric VTE is rarely an idiopathic illness. More commonly it is associated with a chronic underlying medical condition. These data refine our understanding of the spectrum of underlying health conditions in children with VTE. This is limited by the inability to take into account the use of various medications and outpatient interventions that may have contributed to the occurrence of the VTE. Future studies should focus on the epidemiology of VTE within each associated disease category. Disclosures No relevant conflicts of interest to declare.
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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 | 0.004 | 0.014 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.012 | 0.013 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.003 | 0.004 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
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".