104: Mortality, Morbidity and Resource Use Among Infants with Trisomy 21(TR21) Admitted to Level III (L3) Nicus
Bibliographic record
Abstract
TR 21 is by far the most common and well known chromosomal disorder in humans and a common cause of intellectual disability. However, the lack of outcome and resource utilization details among infants with TR 21 admitted to Level 3 NICU's precludes effective antenatal counseling, anticipation of hospital course and resource planning. To determine (i) the mortality, morbidity and resource utilization among infants with TR 21 admitted to L3 NICU (ii) Factors associated with mortality during hospital stay. A retrospective cohort study on infants admitted to the NICU's participating in the Canadian Neonatal Network for the epochs 2004–2009 and 2010–2013 was conducted. Data on demography, resource utilization and outcomes during hospital stay were collected. Association between outcomes (death, length of stay and oxygen at discharge) and predictors (gestational age, gender, outborn, severity of illness (SNAP score), mechanical ventilation (MV) and inotrope use were analyzed. 482 and 438 infants with TR 21 during the two epochs (1% each of all L3 NICU admissions) were identified. The mean (SD) gestational age was 36.5 (3) and 36.4 (3) weeks respectively in the two epochs. In the second epoch, 21 (5%) infants died, 21(5%) of the infants required inhaled nitric oxide and 14 (3%)infants had late onset sepsis. The odds of higher deaths of TR 21 infants were associated with the use of inotropes. On logistic regression analysis, SNAP score, MV and inotrope use had fair association with death, [odds ratio (95% confidence interval) 0.98 (0.94,1.03), 11.1 (0.95,129.7) and 75.1 (10.7,530) respectively. Infants with Trisomy 21 admitted to L3 NICU have a significant mortality rate and receive a fair degree of intensive care support. Results could be used for improving effectiveness of antenatal counseling, planned serial cardiac function monitoring as well as facilitating resource planning at various levels of health care administration.
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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 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| 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".