S325 Risks and Benefits of Colorectal Cancer Screening in Heart, Liver, and Lung Transplant Candidates: A Systematic Review
Bibliographic record
Abstract
Introduction: Acute colonic pseudo-obstruction (ACPO) is a rare condition involving massive colonic dilation without mechanical obstruction, typically affecting critically ill or post-operative patients. Although established treatments exist, recurrent ACPO (rACPO) poses a significant challenge, yet data on its risk factors are limited. This study aimed to characterize and identify risk factors for rACPO. Methods: We conducted a retrospective analysis of patients ≥18 years old with ACPO, identified using International Classification of Diseases, Ninth/Tenth Revision (ICD-9/10) codes from January 2014 to June 2024 across 1,238 Banner Health sites. Data collected included demographics, clinical factors, and dates of ACPO onset, resolution, recurrence, and most recent contact. The primary outcome was the development of rACPO. Fisher’s exact test and the Mann-Whitney U test assessed differences between initial ACPO (iACPO) and rACPO cases. Adjusted Poisson regression assessed risk factors for rACPO with an offset accounting for differing observation times. Results: Two hundred seventy-one ACPO cases in 217 patients (median age 69 years, 33.2% female, 81.1% non-Hispanic White) were identified with 42 (19.4%) having at least 1 rACPO during the study period (median observation time 1,224.5 days). Of all cases, 54 (19.9%) were rACPO with 33 patients having 1, 6 patients having 2, and 3 patients having 3 recurrences. The median time to any recurrence was 136 days (interquartile range [IQR] 30.5-337.5), and was 136 (IQR 32-477.25), 30 (IQR 20-278), and 348 (IQR 193-657) for first, second, and third, respectively. Compared to iACPO, rACPO cases were more associated with electrolyte derangements (64.8% vs 49.3%, P = 0.048) and had a higher median colon diameter (12.8 vs 10.6 cm, P = 0.002). iACPO cases were more often precipitated by surgery (23% vs 1.9%, P < 0.001), and narcotic use (47% vs 22.2%, P = 0.001). No clear precipitating factor was found in 8.3% and 16.7% of iACPO and rACPO cases, respectively. rACPO risk factors included colon diameter >10 cm during iACPO (aRR 2.31, P = 0.017), hypothyroidism (aRR 2.08, P = 0.034), prior intracranial or spinal injury (aRR 1.94, P = 0.036), and African American race (aRR 4.29, P = 0.009). Conclusion: One in 5 ACPO cases were found to be recurrent. rACPO is associated with electrolyte disturbances and less often by postoperative status and narcotic use. rACPO risk factors include African American race, prior intracranial or spinal injury, hypothyroidism, and colon diameter >10 cm during the iACPO episode.
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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 | 0.007 | 0.031 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.009 | 0.009 |
| Bibliometrics | 0.007 | 0.008 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.002 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.009 | 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".