A125 CHARACTERIZATION OF RATES AND PREDICTORS OF VENOUS THROMBOEMBOLISM PROPHYLAXIS IN HOSPITALIZED INFLAMMATORY BOWEL DISEASE PATIENTS AT A TERTIARY CARE CENTRE IN NEW BRUNSWICK, CANADA.
Bibliographic record
Abstract
Inflammatory bowel disease (IBD) patients are at an increased risk for venous thromboembolisms (VTE), especially during hospitalization. Literature has shown that rates of VTE prophylaxis in hospitalized IBD patients are suboptimal. The aim of this study is to characterize the rates and predictors of VTE prophylaxis in hospitalized IBD patients at the Saint John Regional Hospital, NB, Canada. A retrospective chart review of 351 IBD patients hospitalized from June 2010 to June 2016 was conducted. Data pertaining to VTE prophylaxis and clinical characteristics of the patients were abstracted. A linear regression was performed to determine the service where hospitalized IBD patients were more likely to receive VTE prophylaxis. A multivariate log-Poisson regression and a multiple hierarchical multivariate logistic regression were conducted to identify the predictors of VTE prophylaxis. Hospitalized IBD patients admitted to the Internal Medicine or General Surgery service were more likely to receive pharmacological VTE prophylaxis (adjusted OR=2.36; 95% CI: 1.18–4.66; p <0.0001), and those admitted to the Family Medicine or other services were more likely to not receive pharmacological VTE prophylaxis (adjusted OR=3.12; 95% CI: 1.80–6.60; p <0.0001). A strong positive association was demonstrated between the receipt of VTE prophylaxis and IBD patients presenting with rectal bleeding in combination with a high Charlson Comorbidity Index score (OR=2.9; 95% CI:1.67–4.57; p<0.001). A positive medium association was demonstrated between the receipt of VTE prophylaxis and IBD patients with a high risk designation from the Padua VTE Risk Assessment Tool in combination with a higher score on the Charlson Comorbidity Index (OR=1.7; 95% CI: 1.5–2.24; p<0.05) or the presence of a blood abnormality on the complete blood count at the time of admission (OR=2.2; 95% CI: 1.8–4.12; p <0.05). Yearly improvement in rates of VTE prophylaxis were appreciated in IBD patients with a combination of a high risk designation from the Padua VTE Risk Assessment Tool and a higher Charlson Comorbidity Index score. Rates of VTE prophylaxis in hospitalized IBD patients were highest in patients admitted to General Surgery, where surgical procedures are a well-established risk of VTE. Patients with IBD admitted to the non-surgical services were less likely to receive VTE prophylaxis and discrepancies in awareness of the need for VTE prophylaxis in hospitalized IBD patients may account for these trends. Predictors of receiving VTE prophylaxis were a combination of more severe patient presentation and the presence of general VTE risk factors. Dalhousie Medicine New Brunswick Research Program
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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 | 0.000 |
| Bibliometrics | 0.002 | 0.004 |
| Science and technology studies | 0.001 | 0.001 |
| 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".