66: Nosocomial Infection (NI) Trends in Canadian Neonatal Intensive Care Units: Association with Mortality and Morbidity
Bibliographic record
Abstract
As effective treatment for infants born very preterm has decreased mortality, the NI risk in that population has increased. The impact of NI on mortality and morbidity is unclear and the trends in NI rates in Canadian NICUs has not been well documented. To characterize recent trends of NI among preterm infants admitted to Canadian Level 3 NICUs during 2008–2012, and assess the impact of NI trends on trends in neonatal mortality and severe morbidities. A retrospective observational cohort study was performed on infants born <33 weeks gestational age and admitted to 24 NICU sites participating in the Canadian Neonatal NetworkTM during 2008–2012. NICU sites were classified into three groups according to baseline NI rates in 2008 using Cochrane-Armitage trend test (14% or less, 15% to 19%, more than 19%). Data was extracted from health records after discharge using standardized definitions and manual of operations. Association of NI trends and trends in the composite mortality/morbidity were tested using multivariable logistic regression after adjustment for potential confounders and important risk factors. Sites with high baseline NI rates showed significantly decreasing trends in the following years however no significant NI trends were detected for sites with low or medium baseline NI rates. The trend in composite mortality/morbidity was significantly decreased for sites with decreased NI trends (OR 0.89 [95% CI 0.85 to 0.93]), but no significant trend in mortality/morbidity was detected for sites with increased NI rates. However a decreasing trend in mortality/morbidity was also observed in sites with constant NI rates. NI trends decreased only for sites with high baseline NI rates, which indicates that future reporting of NI rates must account for baseline NI rates. NI trends may affect NICU mortality/morbidity but further research must be done to determine the exact relationship between these variables.
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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 | 0.005 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.003 | 0.006 |
| Science and technology studies | 0.002 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 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".