Beyond the consult: Outcomes following pediatric VAD referral
Bibliographic record
Abstract
Background Little is known about patients who are referred for VAD therapy but not implanted. The purpose of this study is to describe their outcomes at 1-year post initial consultation. Methods Retrospective analysis for patients referred to our VAD services between 01/2019 and 12/2023. Outcomes were reported at 30-days and 1-year post consult. Patients who died, were too unwell for VAD or required ECMO within 30-days of consultation were considered acute referrals. Multivariate logistic regression analysis was used to determine risk factors for being an acute referral. Results There were 128 patients included, with median age at referral 2.7years (IQR 0.3, 0.9), 50.8% being male and 52.3% of patients having congenital heart disease (CHD). The primary indication for VAD consult was due to patient undergoing a transplant evaluation. At 30-days 31% (n=41) were considered acute referrals, with 28.1% (n=36) receiving ECMO, 3.1% (n=4) being too unwell for VAD and 0.8% (n=1) patients dying. Patients who were acute referrals and had not received VAD therapy or transplant had worse 1-year survival (p<0.001) then elective referrals, with the highest risk for mortality being early in the course. Diagnosis of biventricular CHD, other (non-CHD, non-cardiomyopathy) or absence of comorbidities were independent factors associated with being an acute referral. Conclusion Of patients referred to the VAD service, one-third were considered acute referrals. Patients who were acute referrals had increased 1-year mortality than those who were elective referrals. Factors associated with being acute referral included diagnosis of biventricular CHD or other, and no comorbidities.
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 | 0.006 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.003 | 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".