Disseminated Intravascular Coagulation Score Is Related to Short-term Mortality in Patients Undergoing Venoarterial Extracorporeal Membrane Oxygenation After Cardiac Surgery
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Bibliographic record
Abstract
Disseminated intravascular coagulation (DIC) score is associated with short-term mortality in various conditions but has not been studied in postcardiotomy cardiogenic shock (PCS) patients supported with venoarterial extracorporeal membrane oxygenation (VA-ECMO). The objective of this study was to evaluate the relationship between DIC score at day 1 from VA-ECMO initiation and short-term mortality. We included all PCS patients supported with VA-ECMO at the Beijing Anzhen Hospital between January 2015 and December 2018. Multivariable logistic regression analysis was performed to assess the relationship between DIC score at day 1 and in-hospital mortality, and adjust for potential confounding variables. Of 222 PCS patients treated with VA-ECMO, 145 (65%) patients were weaned from VA-ECMO, and median (IQR) ECMO support duration was five (3-6) days. In-hospital mortality was 53%. The median (IQR) DIC score at day 1 was five (4-6). Patients with DIC score ≥5 at day 1 (overt DIC) had higher in-hospital mortality as compared with patients with DIC score <5 (64% vs. 22%; P < 0.001). After adjusting for age, sex, ECMO indication, and peak serum lactate, a one-point rise in DIC score [OR, 2.20; 95% confidence intervals (CI), 1.64-2.95] or DIC score ≥5 at day 1 (OR, 4.98; 95% CI, 2.42-10.24) was associated with an increased risk of in-hospital mortality. The area under the receiver operating characteristic curve for DIC score at day 1 was 0.76 (95% CI, 0.69-0.82). Our study suggests that DIC score at day 1 is associated with short-term mortality in patients undergoing VA-ECMO after cardiac surgery, independent of age, sex, disease characteristics, and severity of illness.
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Full frame distilled prediction
Teacher imitationNot 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.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| 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) | 0.000 | 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 it