43: Outcome of Infants with Necrotising Enterocolitis (NEC): The Impact of Laparotomy Versus Peritoneal Drainage
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 randomised trials have shown no difference in early mortality of NEC managed with laparotomy versus peritoneal drain. To compare short term outcomes and neurological morbidities of infants with NEC treated by laparotomy or peritoneal drain. Retrospective multicenter study on infants <33 weeks' gestation born between January 2010 and December 2012 with NEC Stage II or greater, using Canadian Neonatal Network data. Infants were stratified by medical and surgical treatments. Significant difference between group outcomes was assessed using the Pearson χ2 test for categorical variables and Student's t test for continuous variables. Odds ratios with 95% CIs) were calculated using standard methods. A total of 11,974 infants were admitted to 30 CNN NICUs during the study period and 214 of NEC cases (39%) required surgery. Seventy infants were treated with drain or drain and laparotomy; they had significantly lower birth weights and gestational ages, P<0.0001 and higher mortality P<0.001 than the laparotomy group. Both medical and surgical NEC infants had significantly greater rates of IVH and PVL (P<0.0001) compared to no NEC infants with decreased head growth at 36 weeks, (P<0.05). However, there was no difference in adjusted head growth at 36 weeks between those treated with drain or laparotomy at 36 weeks (−0.82 [95% CI −2.40 to 0.77], P=0.30). In contrast to previous studies, we show mortality in the peritoneal drain group is higher. Longer-term neurodevelopmental outcomes will be important to determine best practice.
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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 | 0.004 |
| 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 | 0.001 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 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".