Abstract 34: Low SpO <sub>2</sub> and Lack of Heparin are Associated With Cardiac Catheterization-related Stroke in Children With Congenital Heart Disease
Bibliographic record
Abstract
Introduction: Stroke is an uncommon yet serious complication associated with cardiac catheterization in children with congenital heart disease. Our objective was to estimate the frequency and predictors of arterial ischemic stroke (AIS) in this specific setting. Methods: We performed a case-control study of children with congenital heart disease, who developed stroke in relation to cardiac catheterization performed at the Hospital for Sick Children between 1 January, 1992 and 1 January, 2014. Cases had new AIS (either symptomatic or silent) within 72 hours of cardiac catheterization and controls had cardiac catheterization but no new stroke within this time window. We estimated the frequency of AIS in children who underwent cardiac catheterization in this study period. Predictors of stroke that were tested include age, nature of intra-cardiac shunt, pre-procedural peripheral capillary oxygen saturation (SpO 2 ), type of catheterization (diagnostic versus interventional), duration of procedure, right versus left heart protocol, procedural anticoagulation and major/minor complications. Pediatric Stroke Outcome Measure was used to assess the neurological outcome of cases. Results: Twenty eight children (mean age1.66years; 64% males) developed stroke among 19414 children who underwent cardiac catheterization during the study period. The frequency of cardiac catheterization related-stroke in children is 1.44/1000 cardiac catheterizations. Univariate analysis revealed that younger age (OR 1.22; 95% CI (1.02,1.45); p=0.030), low SpO 2 pre-catheterization (OR 1.08; 95% CI (1.03,1.12); p=0.004), lack of procedural anticoagulation with heparin (OR 3.57; 95% CI (1.04,11.76); p=0.044), and minor complications during catheterization (OR 7.15; 95% CI (1.51,33.79); p=0.013) were associated with stroke. Low SpO 2 pre-catheterization and lack of procedural anticoagulation remained significant in multivariate analysis. Conclusion: The frequency of stroke after cardiac catheterization in children with congenital heart disease is 1.44/1000 cardiac catheterizations. Low SpO 2 pre-catheterization and lack of procedural anticoagulation appear to be associated with a higher risk of stroke.
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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 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| 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 | 0.001 |
| Insufficient payload (model declined to judge) | 0.004 | 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".