Abstract: Low Apgar Score As an Indicator for Prompt Referral to a Specialized Multidisciplinary Team in the Non-Operative Treatment of Obstetrical Brachial Plexus Injuries
Bibliographic record
Abstract
INTRODUCTION: Prompt physical and occupational therapy is crucial in managing non-surgical candidates with Obstetrical Brachial Plexus Injuries (OBPI). The objective of our study was to identify newborns suffering from non-operative OPBI in need of a ‘‘fast-track’’ evaluation by our multidiscipline team. METHODS: Retrospective chart review of single surgeon’s experience of OBPI from June 1995 to June 2015. All non-surgical candidates (Narakas class 1) were included in the study. The Gilbert score and the Medical Research Council grading system were used to measure shoulder and elbow outcomes, respectively. Multiple subgroups analyses were performed to study the impact of time-delay on shoulder and elbow function. The ANOVA test and Welch’s test were used for statistical analysis. RESULTS: A total of 168 patients were included in this study. Mean follow up time was time 313.8 weeks (min:52; max:1072; SD:228.1). Time delay between birth and the first consult to our clinic significantly correlated with shoulder outcome in the subgroup of newborns with Apgar scores <7 at five minutes. The following subgroups did not have a clinically significant association between shoulder outcome and time delay to consult: maternal diabetes, birth weight >4kg, use of forceps, asphyxia, multiple comorbidities, and Apgar score at one minute. Elbow outcomes remained unaffected by time delay in the total population and in all subgroups. CONCLUSION: The subgroup of newborns with an Apgar score <7 at five minutes shows improved long-term shoulder outcome when promptly examined by an OBPI clinic. We recommend that that this ‘‘time-sensitive’’ population should be recognized and assessed by a multidisciplinary team before 12 weeks of age.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 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 teacher head, 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".