A195 SURIVIVAL IN ACUTE ON CHRONIC LIVER FAILURE IN COMPENSATED CIRRHOSIS VS DECOMPENSATED CIRRHOSIS
Bibliographic record
Abstract
Acute on chronic liver failure (ACLF) is a relatively newly coined term describing organ failure and acute decompensation in patients with chronic liver disease. Patients with ACLF have increased risk of short term mortality, as compared to patients with decompensated liver disease without ACLF. A recent study found as compared to patients who have had prior decompensation, patients presenting with new decompensation and ACLF developed a more severe form, with higher rates of mortality. Whether this finding is seen in other populations of patients with liver disease is unknown. To evaluate whether differences exist between patients with compensated cirrhosis who develop ACLF vs patients with decompensated cirrhosis who develop ACLF. Patients with cirrhosis admitted to The Ottawa Hospital (TOH) from July 2014 to July 2016 were retrospectively identified. They were identified by using ICD-10 diagnosis codes of: unspecified cirrhosis of liver, esophageal varices, ascites, hepatic failure, peritonitis, hepatorenal syndrome or postprocedural disorders of the digestive system to identify those with possible cirrhosis. A chart review was done and cirrhosis was confirmed by either liver biopsy, imaging characteristics or documented expert opinion. The charts of those with confirmed cirrhosis were then reviewed to determine whether they developed ACLF at or during admission. ACLF was defined using the European Association for the Study of Liver-Chronic Liver Failure (EASL-CLIF) ACLF definition. Organ failure was defined using the EASL-CLIF organ failures definition. Patients clinical characteristics and survival data up to 12 months from development of ACLF were collected. Groups were compared using Student’s t-test or a chi-squared test. Log-rank test was used to compare the survival of those with compensated cirrhosis who developed ACLF vs those with prior decompensated cirrhosis who developed ACLF. Out of 522 patients identified as having cirrhosis while admitted to TOH from 2014–2016, 94 were identified as having ACLF during their admission. 34 had compensated cirrhosis prior to development of ACLF, 60 had decompensated cirrhosis prior to development of ACLF. Patients with decompensated cirrhosis who developed ACLF were younger (mean age 54.78) than those with compensated cirrhosis who developed ACLF (mean age 59.71) (P 0.0342). The two groups were similar in etiology of cirrhosis, active alcohol use at admission, MELD-NA and MELD at admission, length of stay (LOS), and etiology of ACLF. There was no statistically significant difference in survival up to 12 months after development of ACLF between the two populations (Z = 0.071 P = 0.94). There was no statistically significant difference in survival between patients with compensated cirrhosis who developed ACLF vs patients with decompensated cirrhosis who developed ACLF. 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 | 0.001 |
| Bibliometrics | 0.002 | 0.002 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 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".