A108 EARLY ALBUMIN LEVEL IS ASSOCIATED WITH TIME TO COLECTOMY AND RE-ADMISSION RISKS IN HOSPITALIZED ULCERATIVE COLITIS PATIENTS STARTING INFLIXIMAB
Bibliographic record
Abstract
Approximately up to 30–60% of ulcerative colitis (UC) patients fail to infliximab (IFX) in real-life retrospective studies. Studies investigating early markers of poor clinical outcomes in UC patients starting IFX remain limited. The aim of this study was to investigate early markers of clinical outcomes in hospitalized UC patients starting IFX. A total of 98 hospitalized UC patients (male, 55/98 [56.1%]; median age at first dose of IFX, 32.0 years [IQR 24.5–44.0]; median disease duration, 1.9 years [0.4–4.8]) who started IFX from August 2010 to April 2017 at Mount Sinai Hospital, Toronto were retrospectively investigated. Variables including age, gender, family history of inflammatory bowel disease, smoking history, Mayo score, clostridium difficileinfection, serum albumin, and C-reactive protein (CRP) at the time of IFX initiation were analyzed. Cumulative event-free survivals of clinical outcomes was estimated by Kaplan-Meier curves and the association analysis by Cox proportional hazard regression. Among the 98 patients, 23 (23.5%) underwent colectomy during a median 1.2 months (IQR 0.5–2.4) and 38 (38.8%) re-admitted to the hospital during a median 1.9 months (IQR 1.1–6.1). Hypoalbuminemia (<35 g/L) at the time of IFX initiation was significantly associated with a 5-fold increased risk (aHR 4.99, 95% CI 1.16–21.53) of time to colectomy and a 2.7-fold increased risk (aHR 2.69, 95% CI 1.10–6.58) of time to re-admission, whereas CRP level was not associated with clincial outcomes. Patients with the lowest quartile of serum albumin levels (≤27 g/L) had significantly increased risks of time to colectomy and re-admission compared to the other quartiles. Clostridium difficile infection was associated with increased risk of time to re-admission (HR 2.27, 95% CI 1.04–4.98), although it was not significant in the final multivariable cox model. Early albumin level at the time of IFX initiation is significantly associated with time to colectomy and re-admission risks in hospitalized UC patients, whereas early CRP level is not associated with these outcomes. Univariable and Multivariable Cox Proportional Hazard Regression of Colectomy and Readmission aHR, adjusted hazard ratio; CI, confidence interval; HR, hazard ratio 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 | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| 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".