LSO-103 Childhood-onset systemic lupus erythematosus: long-term outcomes in a large multi-ethnic Ontario cohort
Bibliographic record
Abstract
Background The long-term morbidity and mortality of childhood-onset SLE (cSLE) after transition to adult care is not well-documented. The present study aims to fill this knowledge gap by analyzing outcomes in a large province-wide cSLE cohort. Our objectives were to: 1) determine all-cause and cause-specific mortality rates, adverse renal event rates, cardiovascular event and cancer rates; and 2) determine baseline characteristics associated with higher rates of transition between 3 different states: event-free, adverse renal event, and death. Methods Clinical data were abstracted for cSLE patients diagnosed between January 1990 and March 2011 after contacting all pediatric and adult rheumatologists and nephrologists in Ontario. Data were linked to administrative healthcare databases at ICES to determine the outcomes of interest. We examined descriptive summaries of major outcomes including death, end-stage kidney disease [ESKD] requiring chronic dialysis and renal transplant, cardiovascular events and cancer. We used a multi-state Cox model to determine baseline characteristics associated with higher rates of transition between the 3 states (figure 1). Results There were 37 deaths in a cohort of 601 patients at a mean follow-up time of 14 years. The all-cause mortality rate was 3.43 per 1000 person-years. The rates for ESKD requiring chronic dialysis and renal transplant were 5.34 and 2.16 per 1000 person-years, respectively. The rates for any type of cardiovascular event and cancer were 6.32 and 3.13 per 1000 person-years, respectively. The multi-state model indicated that the non-white ethnic group (HR, 2.15; 95% CI, 1.14–4.08) and the presence of renal involvement at baseline (HR, 2.15; 95% CI, 1.17–3.95) were significantly associated with higher rates of transition from event-free to adverse renal event. Conclusions In this large multi-ethnic cSLE cohort, ethnicity was associated with adverse outcomes including renal events and death. Further analyses will help inform risk for adverse outcomes to improve clinical care for the highest risk patients.
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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 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| 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".