Abstract 18124: Delayed Staged Palliation Does Not Affect Clinical Outcomes for Children With Hypoplastic Left Heart Syndrome and Variants
Bibliographic record
Abstract
Introduction: Impact of delayed stage II and/or Fontan palliation on survival and Fontan physiology is not well understood. Hypothesis: Delayed staged palliation results in lower survival and worse Fontan outcomes. Methods: All 232 patients with HLHS undergoing stage I palliation from 2000-2011 were reviewed (Figure). The clinical course for patients who had delayed stage II (>7 months) or Fontan (>3.5 years) was documented. Patients were classified as having either minor or significant reasons for delayed palliation. Rates of on-time and overall Fontan completion, survival, transplant, and post-Fontan failure were compared between patients who did not meet (G1; n=28) and met (G2; n=125) conventional stage II palliation timelines. Rates of post-Fontan failure were also compared for patients who did not meet (G3; n=44) and met (G4; n=74) conventional Fontan completion timelines. Results: Delayed stage II palliation resulted in equivalent rates of on-time (G1: 15 [53.6%] vs G2: 59 [47.2%]; p=0.54) and delayed (G1: 10 [35.7%] vs G2: 34 [27.2%]; p=0.37) Fontan completion, with no difference noted between rates of delay because of minor or significant reasons (p Conclusions: Delayed timing of stage II and Fontan palliation did not impact survival or Fontan failure. While close followup and sensible rehabilitation strategy are likely contributors to equivalent outcomes, this result may partly be due to patients who never reached subsequent palliation because of inter-stage death or transplant.
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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 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| 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".