MP64-07 REVISITING RISK FACTORS FOR FEBRILE URINARY TRACT INFECTION USING A LARGE PRENATAL HYDRONEPHROSIS DATASET
Bibliographic record
Abstract
You have accessJournal of UrologyPediatrics: Urinary Tract Infection & Vesicoureteral Reflux (MP64)1 Apr 2019MP64-07 REVISITING RISK FACTORS FOR FEBRILE URINARY TRACT INFECTION USING A LARGE PRENATAL HYDRONEPHROSIS DATASET Luis H. Braga*, Smruthi Ramesh, Melissa McGrath, Armando J. Lorenzo, C.D. Anthony Herndon, and Forough Farrokhyar Luis H. Braga*Luis H. Braga* More articles by this author , Smruthi RameshSmruthi Ramesh More articles by this author , Melissa McGrathMelissa McGrath More articles by this author , Armando J. LorenzoArmando J. Lorenzo More articles by this author , C.D. Anthony HerndonC.D. Anthony Herndon More articles by this author , and Forough FarrokhyarForough Farrokhyar More articles by this author View All Author Informationhttps://doi.org/10.1097/01.JU.0000556899.87214.a4AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVES: Risk factors for febrile UTI (fUTI) in infants with prenatal hydronephrosis (HN), such as female gender, uncircumcised status, high grade HN and non-refluxing primary megaureter (NRPM) have been consistently documented in several small sample size series, however the same cannot be said regarding continuous antibiotic prophylaxis (CAP). Herein, we revisit this clinically important outcome using a large single center database to confirm or refute these previous findings. METHODS: Since 2009, we have prospectively followed 876 consecutive prenatal HN infants <12 months of age with the following conditions: UPJO-like, non-refluxing primary megaureter (NRPM) and VUR. Patients with <6months F/U were excluded. A priori collected variables included: HN SFU grade (low-I/II vs. high-III/IV), HN etiology, CAP, gender and circumcision status. Primary outcome was catheter specimen fUTI. Time to event curves (Hazard ratio-HR) were analyzed by Cox proportional regression to adjust for confounders. Analyses were done with and without VUR patients. RESULTS: Of 848 included patients, 632 (75%) were male and 36% were circumcised. 73 (9%) had a fUTI at a median age of 6 months (IQR 9). Mean follow-up was 30 months (6-120). High grade HN was seen in 467 (55%) infants and CAP prescribed for 450 (53%). VUR (68% grades IV-V) was detected in 168/572 (29%) patients who had a VCUG. Upon univariate analysis, a significantly higher fUTI rate was seen in females, uncircumcised males, patients with NRPM and high grade HN (Table 1). In the Cox proportional regression model, NRPM (HR=4.8, p<0.01), VUR (HR=7.0, p<0.01), uncircumcised males (HR=2.3, p=0.03), females (HR=2.5, p=0.02), and lack of CAP (HR=3.7, p<0.01), were significantly associated with fUTI (Table 2). HN grade was not found to be associated with fUTI. KM curves for fUTI risk factors are shown in Fig. 1. CONCLUSIONS: This study validates previous findings, confirming NRPM, VUR, uncircumcised status and female gender as important risk factors for fUTI. According to our large dataset analysis, CAP significantly reduced fUTIs and should be offered to these high-risk HN patients. Source of Funding: none Hamilton, ON; Hamilton, Canada; Toronto, Canada; Richmond, VA; Hamilton, Canada© 2019 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 201Issue Supplement 4April 2019Page: e943-e944 Advertisement Copyright & Permissions© 2019 by American Urological Association Education and Research, Inc.MetricsAuthor Information Luis H. Braga* More articles by this author Smruthi Ramesh More articles by this author Melissa McGrath More articles by this author Armando J. Lorenzo More articles by this author C.D. Anthony Herndon More articles by this author Forough Farrokhyar More articles by this author Expand All Advertisement PDF downloadLoading ...
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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 | 0.016 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.002 |
| Bibliometrics | 0.002 | 0.002 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.022 | 0.013 |
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".