Cognitive dysfunction is greater in patients hospitalised with COPD exacerbations than with worsening heart failure
Bibliographic record
Abstract
Introduction People with COPD have cognitive dysfunction, which is greater in those hospitalised for exacerbations than in stable outpatients [Dodd et al Chest 144:119-27]. Aims We tested the hypothesis that cognitive dysfunction is a disease-specific feature of COPD exacerbations by comparing cognition in patients hospitalised with COPD exacerbations or with worsening heart failure. Methods Patients hospitalised with COPD exacerbations or congestive or left sided heart failure (HF) without previous stroke, neurological disease or alcohol dependence completed the Montreal Cognitive Assessment (MoCA), Hospital Anxiety and Depression score (HAD) and underwent spirometry and review of clinical records. Results Age, acute illness severity and comorbidities were similar in COPD and HF. Table 1. Patient characteristics COPD HF P value Age (years) 73±10 76±11 0.422 Gender (% male) 40 70 0.057 APACHE II 15.4±3.5 15.9±3.0 0.628 Charlson Index 2.3±1.9 2.6±1.5 0.588 Pack years 51±35 11±16 <0.001 FEV 1 :FVC (%) 56±14 71±16 0.024 MoCA was lower in COPD (21.0±5.8) than in HF (24.9±3.6, p=0.013). Visuospatial/executive function (COPD 2.7±1.5; HF 3.9±1.3, p=0.008) and attention (COPD 3.8±1.7; HF 5.0±1.3, p=0.014) were impaired in COPD and anxiety and depression (HAD. COPD 19.6±9.8; HF 13.9±7.5, p=0.045) were increased. On multiple linear regression, HAD (p=0.01), pack years (p=0.033) and age (p=0.008), but not primary diagnosis (COPD/HF) or gender, were independently associated with MoCA. Conclusions Hospitalised COPD patients with exacerbations have greater cognitive impairment than those with worsening heart failure. Differences may be explained by greater smoking load and more anxiety and depression.
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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 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| 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".