A225 VACCINE-PREVENTABLE DISEASES IN HOSPITALIZED PATIENTS WITH END-STAGE LIVER DISEASE/CIRRHOSIS: A NATIONWIDE COHORT ANALYSIS
Bibliographic record
Abstract
Abstract Background Cirrhosis is associated with immune dysfunction, which increases susceptibility to infection and subsequent hospitalization. Vaccination of this high-risk patient population can mitigate the risk of infection. Aims Data from the National Inpatient Sample (NIS) was analyzed to compare the prevalence of vaccine-preventable diseases (VPD) among hospitalized patients both with and without cirrhosis. Methods The 2013 NIS database was interrogated using ICD-9-CM codes to identify patients with cirrhosis and VPD. Baseline characteristics were compared (see: Table 1). Univariate and multivariate regression models identified risks associated with VPD adjusting for survey procedures. Results 313,710 patients were hospitalized for VPD, including 13,080 patients (4.1%) with cirrhosis (see: Table 1) Patients with cirrhosis were more likely to be hospitalized with pneumococcal pneumonia (odds ratio [OR] = 1.45 [95% CI 1.29 – 1.63], P <0.001), hepatitis A (OR = 7.04 [95% CI 5.96 – 8.31], P <0.001) and hepatitis B (OR = 14.41 [95% CI 12.53 – 14.36], P <0.001) infections compared to patients without liver cirrhosis. Patients with cirrhosis were less likely to have an infection with influenza (OR = 0.55 [95% CI 0.49 – 0.62], P <0.001), human papillomavirus (HPV) (OR = 0.57 [95% CI 0.43 – 0.75, P < 0.001) and varicella zoster (OR = 0.78 [95% CI 0.69 – 0.89], P <0.001). Minimal differences in hospitalizations for haemophilus influenzae or meningococcal infections were noted between groups. Odds ratios for VPD adjusting for age, sex, race, patient location, patient income, hospital type and bed-size, mortality risk, type 2 diabetes mellitus, malignancy, human immunodeficiency virus (HIV), organ transplantation and immunodeficiency: pneumococcal pneumonia (OR = 1.27 [95% CI 1.13 – 1.44], P < 0.001), hepatitis A (OR = 5.99 [95% CI 5.02 – 7.15], P < 0.001); and hepatitis B (OR = 11.07 [95% CI 10.24 – 11.97], P < 0.001). Conclusions These results emphasize the importance of vaccinating patients with cirrhosis against pneumococcal pneumonia, hepatitis A and hepatitis B infections to reduce hospitalization Table 1: Baseline characteristics of patients with cirrhosis and without cirrhosis presenting with a vaccine preventable disease. Funding Agencies None
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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 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 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".