Risk Factors for Patient-Important Upper Gastrointestinal Bleeding
Bibliographic record
Abstract
Abstract Rationale Patient-important gastrointestinal bleeding is an endpoint developed by patients and family members; however, risk factors for this outcome are unknown. Objectives We sought to identify risk factors for patient-important upper gastrointestinal bleeding among invasively ventilated adults. Methods This preplanned regression analysis of an international trial database evaluated baseline and time-varying risk factors in the preceding 3 days for patient-important upper gastrointestinal bleeding, accounting for illness severity and the competing risk of death. Measurements and Main Results Patient-important upper gastrointestinal bleeding occurred in the ICU among 131 of 4,821 (2.7%) patients. Baseline APACHE II score—hazard ratio (HR), 1.24 (95% confidence interval [CI] = 1.12, 1.37) per 5-point increase—and the following were associated with greater risk of patient-important bleeding: inotropes or vasopressors (HR, 2.05 [95% CI = 1.35, 3.12]), severe thrombocytopenia (platelet count, <50 × 109/L) (HR, 2.21 [95% CI = 1.24, 3.94]) and platelet inhibitor drugs (HR, 1.69 [95% CI = 1.11, 2.56]). A lower bleeding risk was associated with pantoprazole (HR, 0.36 [95% CI = 0.25, 0.54]) and enteral nutrition (HR, 0.81 [95% CI = 0.68, 0.97]) for every increase of 500 ml/d. There was no interaction between enteral nutrition and pantoprazole (interaction P = 0.94). Allocation to pantoprazole was associated with a lower risk of patient-important upper gastrointestinal bleeding regardless of the volume of enteral nutrition (for 500 ml/d: HR, 0.36 [95% CI = 0.22, 0.58]; for no enteral nutrition: HR, 0.36 [95% CI = 0.18, 0.72]). The association of enteral nutrition and bleeding was similar with pantoprazole (HR, 0.82 [95% CI = 0.63, 1.07]) or without pantoprazole (HR, 0.81 [95% CI = 0.66, 1.00]). Conclusions Several factors are associated with the risk of patient-important upper gastrointestinal bleeding during invasive ventilation.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
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 | 0.005 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 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".