Improvement of Survival in Low Weight Children on Berlin Heart EXCOR Ventricular Assist Device Support
Bibliographic record
Abstract
All articles of this category Objectives: Publications on the pediatric Berlin Heart EXCOR ventricular assist device have revealed that low body weight < 10 kg is a significant risk factor for mortality with children < 5 kg being at highest risk. However, these studies are limited to implantation periods prior to 2011. Since then, progress has been made in optimization of patient selection and management. This study investigated if survival of children weighing < 10 kg supported with the EXCOR assist device improved in recent years and sought to determine risk factors for mortality. Methods: The Berlin Heart EXCOR prospective registry ( n = 1,832) between 2000 and 2017 was retrospectively reviewed to compare the outcomes of different weight cohorts A (< 5 kg) ( n = 204), B (5–10 kg) ( n = 633), and C (> 10 kg) ( n = 995) in different eras (era 1: January 2000–December 2012 [ n = 1,089], era 2: January 2013–June 2017 [ n = 743]). Results: Overall survival in groups A and B significantly increased from era 1 to era 2 (group A: 51 vs. 65%, p < 0.001; group B: 74 vs. 78%, p = 0.001) whereas it remained stable in group C (78 vs. 73%). In era 2, the survival of group B was not significantly different than group C. On multivariable analysis of children < 5 kg, congenital heart disease, preoperative extracorporeal life support, and biventricular support were independently associated with increased mortality in era 1 (hazard ratio: 2.04 [95% CI: 1.18–3.53]; 2.44 [1.36–4.37]; and 1.93 [1.11–3.34], respectively) but not in era 2. Conclusion: Pediatric EXCOR ventricular assist device therapy has improved significantly for children weighing < 10 kg. Withholding of a VAD is not justified on the basis of body weight alone.
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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 | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| 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".