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Record W2926603168 · doi:10.3389/fphys.2019.00328

Aging and Comorbidities in Acute Pancreatitis I: A Meta-Analysis and Systematic Review Based on 194,702 Patients

2019· review· en· W2926603168 on OpenAlex

Why this work is in the frame

A frame that forgets how it found something cannot be audited. These are the routes that admitted this work.

aboutThe title or abstract carries a Canadian signal from the geographic lexicon.
no affNo Canadian affiliation: this work is invisible to an affiliation-only frame.
No Canadian affiliation. An affiliation-only frame, the usual design, would never have seen this work. It is one of the works that make the case for inverting the frame.

Bibliographic record

VenueFrontiers in Physiology · 2019
Typereview
Languageen
FieldMedicine
TopicPancreatitis Pathology and Treatment
Canadian institutionsnot available
FundersNational Research, Development and Innovation OfficeEmberi Eroforrások MinisztériumaMagyar Tudományos Akadémia
KeywordsFunnel plotMedicineMeta-analysisPublication biasIncidence (geometry)Systematic reviewAcute pancreatitisInternal medicineMortality rateRandom effects modelMEDLINEForest plot

Abstract

fetched live from OpenAlex

Acute pancreatitis (AP) is one of the most common cause of hospitalization among gastrointestinal diseases worldwide. Although most of the cases are mild, approximately 10%-20% of patients develop a severe course of disease with higher mortality rate. Scoring systems consider age as a risk factor of mortality and severity (BISAP;>60yrs, JPN>70 yrs, RANSON;>55yrs, APACHE II>45 yrs). If there is a correlation between ageing and the clinical features of AP, how does age influence mortality and severity? This study aimed to systematically review the effects of aging on AP. A comprehensive systematic literature search was conducted in the Embase, Cochrane and Pubmed databases. A meta-analysis was performed using the preferred reporting items for systematic review and meta-analysis statement (PRISMA). A total of 1100 articles were found. After removing duplicates and articles containing insufficient or irrelevant data, 33 publications involving 194 702 AP patients were analyzed.Seven age categories were determined and several mathematical models, including conventional mathematical methods (linear regression), meta-analyses (random effect model and heterogeneity tests), meta-regression, funnel plot and Egger’s test for publication bias were performed. Quality assessment was conducted using the modified Newcastle–Ottawa scale.The meta-analysis was registered in the PROSPERO database (CRD42017079253). Aging greatly influences the outcome of AP. There was a low severe AP incidence in patients under 30(1.6%); however, the incidence of severe AP showed a continuous, linear increase between 20 and 70(0.193%/year) of up to 9.6%. The mortality rate was 0.9% in patients under 20 and demonstrated a continuous linear elevation until 59,however from this age the mortality rate started elevating with 9 times higher rate until the age of 70.The mortality rate between 20 and 59 grew 0.086%/year and 0.765%/year between 59 and 70. Overall, patients above 70 had a 19 times higher mortality rate than patients under 20. The mortality rate rising with age was confirmed by meta-regression (coefficient:0.037CI:0.006–0.068,p=0.022;adjustedr2:13.8%),and severity also (coefficient:0.035CI:0.019–0.052,p<0.001;adjusted r2:31.6%). Our analysis shows a likelihood of severe pancreatitis, as well as, pancreatitis-associated mortality is more common with advanced age. Importantly,the rapid elevation of mortality above the age of 59 suggests the involvement of additional deteriorating factors such as co-morbidity in elderly.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

Full frame distilled prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.

metaresearch head score (Codex)0.000
metaresearch head score (Gemma)0.000
Version: codex-gemma-dda1882f352aValidation status: machine_predicted_unvalidated
Candidate categoriesMeta-epidemiology (narrow)
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Systematic review · Consensus signal: none
GenreCandidate signal: Review · Consensus signal: Review
Teacher disagreement score0.756
Threshold uncertainty score1.000

Codex and Gemma teacher scores by category

CategoryCodexGemma
Metaresearch0.0000.000
Meta-epidemiology (narrow)0.0010.000
Meta-epidemiology (broad)0.0120.001
Bibliometrics0.0010.001
Science and technology studies0.0000.000
Scholarly communication0.0000.000
Open science0.0000.000
Research integrity0.0000.000
Insufficient payload (model declined to judge)0.0000.000

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.

Opus teacher head0.042
GPT teacher head0.319
Teacher spread0.278 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it