A107 POSTOPERATIVE OUTCOMES AMONG USTEKINUMAB TREATED CROHN’S DISEASE PATIENTS: A MULTICENTRE CANADIAN PROVINCIAL EXPERIENCE
Bibliographic record
Abstract
Ustekinumab (UST), an anti IL12/23 inhibitor, has been recently approved for the treatment of moderate to severe Crohn’s disease (CD) in Europe and the United States. In Canada, UST has been used off-label for CD patients failing anti-TNF therapy. We aim to review postoperative safety outcomes for UST-treated CD patients which has not been previously reported. A retrospective chart review of UST-treated CD patients at two tertiary care academic centres (University of Calgary, University of Alberta) who underwent abdominal surgery between April 1, 2013 and July 31, 2016 was performed. The primary outcome was occurrence of postoperative complications stratified by timing [early (<30 days) vs. late (≥30 days to 6 months) post surgery]. Nineteen UST-treated CD patients underwent abdominal surgery. Patients was exposed to UST preoperatively [median 7 months (IQR 3–12 months)] and continued postoperatively. Median postoperative follow-up was 14 months (IQR 7–22 months). Seven patients (36.8%) had perioperative prednisone (≥20mg/day) with 5 patients (26.3%) used in combination with immunomodulator (azathioprine or methotrexate). No patient has diabetes mellitus. Bowel obstruction was the leading indication for surgery (12/19, 63.2%) and most surgeries occurred in the emergency setting (10/19, 52.6%) via open laparotomy (13/19, 68.4%). One patient experienced an early postoperative wound infection, following his index emergency laparotomy for bowel perforation while on combination prednisone, methotrexate and UST. No other patients experienced early or late postoperative anastomotic leakage, abscess or non-surgical site infections. Three patients (15.8%) reported postoperative ileus and all resolved with conservative treatment. There were no deaths. In this small series, pre-operative UST did not appear to be associated with an increase in postoperative complications. Baseline patient demographics, n=19 None
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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 | 0.001 | 0.004 |
| Science and technology studies | 0.002 | 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".