Pneumonia as a modifiable risk factor of mechanical ventilation in cervical spinal cord injuries
Bibliographic record
Abstract
RATIONALE: Spinal cord injuries greatly impact morbidity and mortality. High cervical injury level often leads to the need of definitive airway. Whether pneumonia is a modifiable risk factor for mechanical ventilation (MV) and prolonged MV in this population is unclear in the literature.OBJECTIVES: The objective of this study was to determine whether pneumonia is an independent risk factor for MV and prolonged MV.METHODS: We conducted a retrospective chart review of consecutive cervical spinal cord injuries admitted to the Hôpital Sacré-Coeur de Montreal in the last 10 years. Eligible patients were identified using the local spinal trauma registry. We recorded data related to the mechanism and type of injury, patient demographics, duration of MV, respiratory complications, intensive care unit and hospital length of stay, and patients’ outcomes. Univariate logistic regression and multivariate logistic regression were performed to determine statistically significant predictors of MV and prolonged MV.MEASUREMENTS AND MAIN RESULTS: Between 2005 and 2014, 348 consecutive cervical injured patients were included. In the multivariate analysis, the presence of pneumonia (odds ratio (OR) 7.42; 3.02–18.27) was independently associated with the need for intubation and the presence of ventilator-associated pneumonia (OR 5.16; 2.00–13.27), was significantly associated with prolonged MV. The median duration of MV was 32.0 days (interquartile range [IQR] = 48.0) in patients with ventilator acquired pneumonia (VAP) compared to 7.0 days (IQR =20.0) in patients without VAP (p < 0.01).CONCLUSIONS: In conclusion, respiratory infection in the cervical spinal injured population is an important factor leading to intubation and prolonged MV.
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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 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 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".