Proton-pump inhibitor use and risk of community-acquired pneumonia in congenital heart disease patients
Bibliographic record
Abstract
Adults with congenital heart disease (CHD) are at elevated risk of hospitalization for community-acquired pneumonia (CAP). Proton-pump inhibitors (PPIs) have been shown to be a risk factor for CAP in adult and pediatric general populations. This study explored the association between PPI use and subsequent CAP hospitalizations in the adult CHD population. Using the Danish National Patient Registry, we performed a nested case-control study of adults with CHD who had been admitted to the hospital for CAP between 1996 and 2017. The timing and dose of PPI were evaluated in the year preceding the CAP admission. Logistic regression measured the impact of timing and dose of PPI on the subsequent CAP admission. In total, 618 adult CHD patients were admitted for CAP during the study period. The adjusted odds ratio (OR) was 2.21 (95% confidence interval (CI) 1.66–2.94) for CAP in current PPI users compared with non-users. The OR amongst current PPI users was further elevated for males, those older than 65 years old and those with severe/univentricular CHD [3.59 (95% CI 2.33–5.52), 2.30 (95% CI 1.55–3.41), 2.35 (95% CI 1.13–4.87)], respectively. Segmenting by dose, the OR for CAP patients taking low-dose and high-dose PPI was 2.11 (95% CI 1.38–3.22) and 2.29 (95% CI 1.60–3.26), respectively. Adults with CHD prescribed a PPI are at elevated risk of hospitalization for CAP in the following 90 days. The risk for CAP admission is further increased for those prescribed high-dose PPIs, males, those older than 65 years of age, and those with severe/univentricular CHD.
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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 | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| 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".