A321 CANADIAN HOME TOTAL PARENTERAL NUTRITION REGISTRY: 10 YEARS OF DATA ENTRY
Bibliographic record
Abstract
Ten large HTPN centers collect and enter clinical data in the Home Total Parenteral Nutrition (HTPN) registry. This is the first Canada-wide registry looking at this population To assess the 10-year clinical data in this cohort of patients A web-based database prospectively collecting information on Patient demography, Nutritional assessment, Medications, Indications for HTPN, Gastrointestinal anatomy following surgeries, HTPN, Blood, Vascular access, Hospitalizations, Mortality, Liver complications, Metabolic bone disease, Quality of life on a two-year bases A total of 735 patient charts have been entered in the database, with a total of 1380 entries. Four centers reached the 10-years follow-up time point. The median age of patient population is 60 years (IQR: 51–70), with 62.5% being females. Short bowel syndrome (SBS) represents 42% of indications, tumours represent 24%, surgical complications 23%, motility disorders 13%, mucosal defects 6%, pancreatic disorders 1%, and other indications are 16%, with some overlap. Considering patients who reached the 10 years mark, mean values at baseline and at 10 years follow-up are the following: AST 51.5 ± 48.5 U/L vs. 35.2 ± 16.9 U/L, ALT 39.9 ± 36.7 U/L vs. 36.7 ± 27.7 U/L ALP 275.1 ± 329.0 U/L vs. 213.8 ± 244.3 U/L and total bilirubin 12.9 ± 8.0 U/L vs. 23.9 ± 44.3 U/L respectively, with statistically significant difference for ALP (p-value <0.02). Liver disease was reported in 186 patients representing 26% of population (n=721); in 108 patients, physicians judged it TPN-related (58% of liver disease). To treat liver disease, in 80% of cases lipids and/or dextrose content has been reduced in the regimen (dextrose only reduction in 9%, lipids only reduction in 39% and both in 32%). In addition, 146 patients were prescribed with ursodeoxycholic acid, 48 took antibiotics, 54 used carnitine and 4 were supplemented with choline (with some overlaps between them). Intralipid and SMOF are lipid emulsions used respectively in 53% and 43% of patients. Overall, 54% of patients have a Karnofsky Performance status of 80 or greater The HTPN registry is a valuable tool to collect relevant information on HTPN patients. SBS is still the leading indication, however cancer and surgical complications are becoming a more frequent indication for TPN. TPN related liver disease is not uncommon, and typically managed by adjusting lipid and/or dextrose content in TPN solution. There is no significant effect of TPN on liver enzymes modification nor on bilirubin and a favorable impact on ALP Baxter and Ontario Medical Supplies
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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 | 0.002 | 0.009 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.006 | 0.014 |
| Science and technology studies | 0.002 | 0.000 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.011 | 0.004 |
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".