Clinical Presentation and Management of Nephrolithiasis in the Obstetric Patient: A Matched Cohort Study [07N]
Bibliographic record
Abstract
INTRODUCTION: Nephrolithiasis is a common medical condition, but little is known about its occurrence in pregnant patients. The study objective is to compare the clinical presentation and management of nephrolithiasis in pregnant women compared with non-pregnant women. METHODS: A retrospective matched-cohort study was conducted using the United States' Healthcare Cost and Utilization Project-Nationwide Inpatient Sample database from 1999 to 2015. ICD-9 coding was used to identify women with nephrolithiasis within this cohort. Pregnant women with nephrolithiasis were identified and age matched (1:1) to non-pregnant women with nephrolithiasis. Conditional logistic regression, adjusted for baseline characteristics, was used to compare the clinical presentation and management of nephrolithiasis in pregnant versus non-pregnant women. RESULTS: There were 30,006 pregnant patients with nephrolithiasis in the cohort. Pregnant women, relative to non-pregnant women, were more likely to be treated in urban teaching hospitals and to have private health insurance. Pregnant patients were less likely to present with classic clinical symptoms of nephrolithiasis, such as flank pain, OR 0.48 (95% CI 0.45–0.53), hematuria, 0.79 (0.73–0.86), and fever, 0.17 (0.13–0.22). Pregnant patients displayed shorter lengths of stay in hospital (3 days or more, 0.81 (0.78–0.84) and were less likely to be affected by infectious conditions, namely urinary tract infections, 0.56 (0.53–0.58), sepsis, 0.14 (0.12–0.16), and pyelonephritis, 0.38 (0.36–0.42). All invasive and surgical procedures were more frequently practiced in the non-pregnant group. CONCLUSION: Pregnant women admitted with nephrolithiasis appear to have a milder disease course as compared to age-matched non-pregnant women, likely suggesting better access to care and a lower threshold for admission.
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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 | 0.000 | 0.001 |
| 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".