Risk factors, Presentation, Diagnosis and Management Factors Associated with Surgery and Death in Ischemic Colitis Patients-A Retrospective Cohort Study
Bibliographic record
Abstract
Colonic ischemia affects older patients with co-morbidities and is usually self-limited but, in certain patients, it can be fatal.It is be suspected in any patient who presents with acute abdominal pain and bloody diarrhea and is usually diagnosed on imaging. Methods:We searched all cases of ischemic colitis based on diagnostic codes from admissions at St Joseph's Healthcare from 2010 to 2017.The patient records were reviewed to confirm diagnosis, and clinical data collected and analyzed regarding their admission.Results: A total of 693 patients were identified, and after exclusion, 144 were reviewed for analysis.The mean age was 70.1 years (range 27-99, SD 15), and mean length of admission was 12 days (range 0-119).Most common patient symptoms were abdominal pain (119) and hematochezia (95).Comorbidities included 73% with hypertension, 44% with dyslipidemia, 31% with coronary disease, and 27% with diabetes.A diagnostic CT was done in 93 patients (65%), and a colonoscopy in 79 (55%).Antibiotics were used in 43% of patients and blood transfusion required in 7%.Mortality was 16.6% and surgery was 15.9%.Complications of sepsis were 10.4% and acute kidney injury in 6.3%.Ris of death was associated with sepsis (p=0.004),elevated INR on presentation (p=0.02), and history of atrial fibrillation (p=0.03).Risk for surgery was significantly related with sepsis (p= 0.026).Conclusion: Ischemic colitis was associated with a high mortality of 16.6% and high risk of surgery of 15.9%.Awareness of risk factors for poor outcome may help identify high risk patients.In our study, death was associated with patients who presented with elevated INR, past history of atrial fibrillation and those who developed sepsis.
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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 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 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".