Abstract 18459: Outcomes of Pediatric Heart Failure Related Hospitalizations in Canada:2004-2013
Bibliographic record
Abstract
Introduction: Heart failure (HF) in children is an important cause of morbidity and mortality with frequent hospitalizations. We sought to describe the prevalence, causes and outcomes of heart failure hospitalizations (HFH) in Canada during a contemporary 10-year time frame and compare the Canadian experience with the U.S experience. Methods: All HFH with heart failure as a primary or secondary diagnosis between 2004 and 2013 in patients Results: A total of 4,693 HFH occurred among 3,523 children, with annual number of hospitalizations ranging from 435 to 559 (7-10 HFH/100,000 children). Infants were the most commonly affected age group (73.6% of all admissions). Congenital heart disease (CHD), cardiomyopathy, and acquired heart disease were associated with 76.1%, 10.5% and 4.2% of HFH respectively. Ventricular septal defect was the most common CHD lesion (33%). Median length of stay (LOS) for all HFH was 10.7 days (IQR 4.1 - 28.7) and was highest in the 0-30 day age group at 21.7 days (IQR 8.1 - 46.6). The in-hospital mortality rate was 8.8%, with the majority of deaths occurring during the index hospitalization. Extra-corporeal life support (ECLS), ventricular assist-device implantation (VAD) and cardiac transplantation occurred in 2.4%, 0.7% and 1.9% respectively. 31.5% of HFH had cardiac surgery and/or catheterization. For patients discharged alive, the cumulative 30-day readmission rate was 12.5%. Conclusions: Pediatric HFHs in Canada are a high-risk event with a significant risk for death and early readmission after discharge. Canadian data shares some similarities with that of the U.S with few pertinent differences. Infants remain the most commonly affected group with CHD seen in the majority of the HFH. ECLS, VAD and cardiac transplant including crude hospital mortality rates are similar in both jurisdictions. HFH rates are lower in Canada as compared to U.S (7-10 v/s 14.5-17.9 per 100,000 children/year). Over the ten-year study period, the annual hospitalization rate has declined significantly in Canada by 3% per year, which differs from the United States where the hospitalizations have remained constant.
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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 | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.002 | 0.005 |
| Science and technology studies | 0.002 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.004 | 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".