54: Outcome of Infants with Necrotising Enterocolitis (NEC): The Impact of Laparotomy Versus Peritoneal Drainage on Neurodevelopment
Bibliographic record
Abstract
NEC remains a major cause of morbidity and mortality in very low birth weight infants. Surgery is required in a third of cases, however randomized trials have shown no clear advantage of laparotomy versus peritoneal drain for initial management, although data on neurodevelopment is lacking. To examine outcome and neurodevelopment at 18 months of infants with NEC treated by laparotomy or peritoneal drain. Data was examined on all infants <29 weeks gestation (GA) born between January 2010 and December 2011 with NEC Stage II or greater, admitted to Canadian Neonatal Network (CNN) NICUs and followed to 18 months. Infants were stratified by medical and surgical treatments. Significant difference between group outcomes was assessed by Fisher's exact test and ANOVA test for categorical and continuous variables, respectively. Odds ratios with 95% confidence intervals (CIs) were calculated using standard methods. 3,233 infants <29 weeks GA were admitted to CNN sites during study period and 260 developed NEC. 174 infants survived to discharge and detailed neurodevelopmental data was obtained on 152 (87%). Infants treated with drain or drain and laparotomy had significanly lower birth weights, longer length of stay and higher mortality than the laparotomy group. At 18 months, head, weight and linear growth remained significanly lower in the drain group, however there were no significant differences in the rates of cerebral palsy, vision or hearing impairments or neurodevelopmental in the treatment groups. Mortality in the drain group is higher, however long term neurodevelopmental outcomes are similar for both surgical groups.
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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 | 0.000 | 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) | 0.001 | 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".