Factors associated with cognitive dysfunction in COPD patients hospitalised with exacerbations
Bibliographic record
Abstract
Introduction COPD patients awaiting hospital discharge following exacerbation have cognitive impairment, which is worse than that seen in stable COPD patients and doesn't improve over 3 months [Dodd et al Chest 144:119-27]. Aims We determined factors associated with cognitive impairment in COPD during acute exacerbation and examined associations between cognition and time from hospital admission. Methods COPD patients with exacerbations without known neurological disease or alcohol dependence were recruited from hospital wards. Participants completed Montreal Cognitive Assessment (MoCA), Hospital Anxiety and Depression score (HAD), COPD Assessment Test (CAT) and underwent spirometry and clinical record review. Results 20 COPD patients (age 73±10 years, 40% male, FEV 1 42±19% predicted, 3.1±3.4 days from admission) had MoCA 21.0±5.8. Sixteen (80%) had cognitive impairment (MoCA <26/30). MoCA decreased with increasing age (r=-0.59, p=0.006), Charlson Index (r=-0.69, p=0.001) and random blood glucose (r=-0.57, p=0.034) and increased with time from admission (r=0.56, p=0.010). MoCA was not significantly associated with smoking (pack years), airflow obstruction, acute illness severity, C-reactive protein, CAT or HAD. On multiple linear regression, age, Charlson index, random glucose and time till assessment were not independently associated with MoCA. Conclusions Hospitalised patients with COPD exacerbations have considerable cognitive impairment, associated with age and comorbidity, rather than smoking load, airflow obstruction or exacerbation severity. However, association with time from admission indicates acute worsening of cognition with exacerbation that initially improves with recovery.
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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 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 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".