The Outcome of Immediate Administration of Dexamethasone in Children With Croup (Laryngotracheobronchitis) in King Abdullah Specialized Children’s Hospital
Bibliographic record
Abstract
Background Croup is an inflammatory disease that affects the upper respiratory tract involving the upper airways of the lungs (bronchial tubes), vocal cords (larynx), and windpipe (trachea). In Canada, it is considered one of the major causes of respiratory diseases in the first 10 years of life. A wide range of viruses like common cold and flu (influenza) infections can cause croup (laryngotracheobronchitis). Dexamethasone has been commonly used to treat croup even though it lacks evidence on patients' recovery. The study aimed to compare the effect of the immediate or late dexamethasone administration on patient recovery and identify predictors for relapse among children with croup. Methods A retrospective cross-sectional study was conducted using the electronic medical record (Best Care) of all croup patients between 2014 and 2018 in King Abdullah Specialized Children's Hospital (KASCH), in Riyadh, Saudi Arabia. Out of the 329, only 186 patients matched our inclusion criteria. Statistical analysis was conducted with the SPSS V.22 software package (IBM Corp., Armonk, NY). The main outcome variable was early recovery or relapse. The chi-square test and logistic regression were used to assess the relationship between the independent variables with recovery or relapse among croup patients. A p-value of <0.05 was used to determine the significance of the test. Results Fifty-three recovered out of the 186 patients. Moreover, 50 of the recovered patients were treated in the ER. In addition, out of the 53 patients who recovered, 40 patients were treated as inpatients (IPs). Those who were given dexamethasone immediately for both recovery and relapsed groups were 29% and 71%, respectively while those who were given dexamethasone late were 34% for the recovery group. On the other hand, 119 patients relapsed. Out of those patients who relapsed, 111 were treated in the ER. Moreover, out of relapsed patients, 79 patients were treated as IPs. Furthermore, out of 186 patients, 86 had chronic illnesses. Twenty-four percent (24%) of those with chronic illnesses recovered, and 76% relapsed (P-value=0.04). Also, there was a significantly higher trend of administration of dexamethasone immediately in the ER in 69% of children with a p-value <0.001. Conclusion In conclusion, the difference between the early and late administration of dexamethasone in both recovery and relapse is not significant. Also, the presence of chronic illnesses affects relapses more significantly.
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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 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 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".