PP241 Topic: AS24–Resuscitation, Stabilization & Transport: Rapid Response Teams/ECMO Transport/Air Transport/Telemedicine/Other: A COMPARISON OF OUTCOMES FOR UNPLANNED PEDIATRIC INTENSIVE CARE UNIT ADMISSIONS FROM THE EMERGENCY DEPARTMENT AND THE WARD: A RETROSPECTIVE COHORT STUDY
Bibliographic record
Abstract
Aims & Objectives: Differences in Pediatric Intensive Care Unit (PICU) outcomes by source of admission are not well studied. This study compares severity-of-illness, frequency of critical interventions within 1 hour and 12 hours of PICU admission, and PICU length of stay (LOS) in children admitted from the Emergency Department (ED) and children transferred from the ward within 48 hours of ED admission. Methods: Retrospective chart review of 6 years of PICU admissions at a single centre (IWK Health, Halifax, Canada). Results: Compared to ED admissions (n=432), ward admissions (n=98) were younger (median [IQR] age 2.2 [0.4-6.8] vs 5.2 [1.5-11.2] years, p<0.001) and more often medically complex (29% vs 17%, p=0.01). Median (IQR) Pediatric Index of Mortality III for ward admissions was 0.5% (0.2,1.8) vs 1.2% (0.3,2.1) for ED admissions, p=0.004. No significant differences were observed between ward admissions and ED admissions in frequency of critical interventions initiated within 1 hour of PICU admission (11% vs 19%; adjusted odds ratio 0.55; 95% CI 0.25-1.09; p=0.10), nor within 12 hours of PICU admission (21% vs 25%; adjusted odds ratio 0.76; 95% CI 0.42-1.32; p=0.3). After adjusting for co-variates, PICU LOS was 42% longer (95% CI 18-70%, p<0.001) for ward admissions (median 3 days, IQR 2-6) vs ED admissions (median 2 days, IQR 2-3). Conclusions: Although the frequency with which critical interventions were initiated within 1 and 12 hours of PICU admission did not differ by source of admission, ward admissions had lower severity-of-illness and longer PICU LOS than ED admissions. Keywords: patient outcomes, critical interventions, unplanned admissions
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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 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.003 | 0.003 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.017 | 0.003 |
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".