127: Prediction of Functional Outcomes at 4.5 Years of Age After Complex Cardiac Surgery
Bibliographic record
Abstract
It is important to identify early predictors of functional limitations in children after congenital heart surgery in order to optimize their independence as they prepare for school. The purpose of this study is to determine potentially modifiable predictor variables of functional outcomes in children at 4.5 years of age with congenital heart disease who underwent complex cardiac surgery at six weeks of age or earlier. This prospective inception cohort study comprised a sample of 165 survivors (63% boys) who had complex cardiac surgery (75% biventricular repairs). We excluded children with chromosomal abnormalities. When children were 4.5 years of age, the parents completed the Adaptive Behavioral Assessment System II questionnaire (ABAS). Regression analysis was used to assess the association between multiple risk factors and each of the four continuous outcomes. The mean scores for the practical domain and general adaptive composite (GAC) score of the ABAS were lower than the conceptual and social domains, with 13.3% of the children having a delay (score >2 SD below the population mean) in the practical domain and 14% of the children having a delay on the GAC. There was a significant association between the GAC (P=0.003; P=0.012), conceptual (P=0.0004; P=0.042), social (P=0.0007; P=0.028) and the practical (P=0.046; P=0.003) domain composite scores and mother's education and highest pre-operative plasma lactate respectively. Maternal education may be a marker for the social context of children, and warrants societal attention to improve functional outcomes. Pre-operative lactate is a potentially modifiable variable that predicts adverse functional outcome. Much effort is already being made to optimize hemodynamics pre-operatively, focusing on the measured lactate; however, continued advances in peri-operative management may yield yet more improvement in this regard, and result in improved outcomes.
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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 | 0.001 | 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".