P433 Postsurgical recurrence in Crohn's disease. Multicenter study in the region of Murcia, Spain of GEMEII group
Bibliographic record
Abstract
Background: Postsurgical recurrence in Crohn'se disease is a frequent problem. Severity of endoscopic reccurrence, correlates with the later development of clinical recurrence, its severity and also with complications and requirement of new surgery. The objective of the present study is to describe the characteristics of Crohn's disease patients included, determining associated presurgical parameters with the intervention, and characteristics associated with the postsurgical recurrence of the disease, evaluating the endoscopic recurrence through the Rutgeerts Index in the 12 months after the surgery. Methods: Multicenter retrospective longitudinal study in the Region of Murcia in Spain. 6 hospitals participated. Includes patients of Ileo-Cecal Crohn's disease during 5 years, from January of 2008 to January of 2013. Variables: sociodemografics, tobacco, Montreal classification, disease severity, treatment prior to intervention and after surgery, cause of intervention, endoscopic control during the year of the intervention and need of therapeutic intensification based on the endoscopic activity after surgery. Statistical analysis by means of Epinfo program: bivariant analysis of association between the different variables gathered and variable results defined by the necessity of surgery, the postsurgical recurrence and the response to the medical treatment after the surgery. Results: 71 patients: (49 men and 22 women) with average age of 35.8 years (DS: 13.2). Inflammatory phenotype 27%, fibro-estenotic 24% and fistulyzing 49%. Smokers to diagnosis 49%. Rutgeerts endoscopyc index at the year of surgery: 75% i0–i1; 25% superior to i1. In the bivariant analysis the positive findings for association were: presurgical corticodependence and presence of endoscopic activity at the year of the surgery (Rutgeerts >i0) with OR=3.24 (CI 1.04–10.07); previous biological treatment to Surgery: with Infliximab and Rutgeerts recurrence >i0 with OR=5.9583 (CI 1.5707–22.6018). With Adalimumab OR=3.8462 (CI 1.0849–13.6350. Association between sex, age, phenotypic pattern (Montreal), tobacco or cause of surgery with endoscopic recurrence to the year of surgery has not been obtained. Table 1. Bivariant analysis Conclusions: Only 25% of our patients presented index of endoscopic recurrence to the year of the surgery of high risk of progression (i2–i4 of Rutgeerts). In our environment, the biological treatment and corticodependence previous to the surgery are associated with endoscopic activity in the year of the surgical intervention.
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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 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| 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".