515. Neurological Complications in Children Hospitalized for Influenza, 2010 to 2022, the Canadian Immunization Monitoring Program Active (IMPACT)
Bibliographic record
Abstract
Abstract Background Influenza-associated neurological complications are rare, but can cause significant morbidity and mortality. We aimed to estimate the proportion of children with neurological complications among those hospitalized for influenza and to identify associated risk factors. The secondary objective was to compare the risk of severe outcomes among children with neurological complications to that of those without. Methods Prospective active surveillance was conducted in 12 pediatric hospitals from the Immunization Monitoring Program, ACTive (IMPACT), representing >90% of all tertiary pediatric beds in Canada. We included patients aged ≤ 16 years hospitalized for microbiologically confirmed influenza during the 2010-11 to 2021-22 influenza seasons. Regression analyses were used to calculate adjusted odds ratios (aORs) for factors associated with neurological complications (seizure, meningitis, encephalitis, myelitis, encephalopathy, radiculopathy, cerebral edema, hydrocephalus, or stroke). The risk of severe outcomes (intensive care unit admission, mechanical ventilation, or death) in children with neurological complications was compared to that of children without these complications using the Chi-square and Wilcoxon tests. Results Among the 9533 children hospitalized for influenza, 1228 (12.9%) had neurological complications. Children with neurological complications had longer hospitalization (6.3 days vs 4.5 days, p < 0.001) and were at higher risk of intensive care unit admission (31.8% vs 14.1%, p < 0.001), mechanical ventilation (20.5% vs 4.4%, p < 0.001), and death (2.2% vs 0.3%, p < 0.001). In a multivariable model adjusting for IMPACT site and influenza type, factors associated with neurological complications were: pre-existing neurological condition (aOR 4.19, 95% CI 3.61-4.86); age between 6 and 24 months (aOR 1.62, 95% CI 1.29-2.03) and age between 2 and 4 years (aOR 1.36, 95% CI 1.09-1.71). Conclusion More than one in ten children hospitalized for influenza developed neurological complications and these were associated with higher risk of severe outcomes. Risk factors identified for neurological complications were age between 6 months and 4 years and the presence of a pre-existing neurological condition. Disclosures Shaun Morris, MD, MPH, DTM&H, FRCPC, FAAP, GSK Canada: Advisor/Consultant|GSK Canada: Honoraria|Pfizer: Advisor/Consultant|Pfizer: Honoraria|Sanofi Canada: Advisor/Consultant|Sanofi Canada: Honoraria Jesse Papenburg, MD, MSc, Merck: Honoraria|Merck: Site investigator, RCT
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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 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.000 |
| 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".