Bibliographic record
Abstract
Background Community-acquired pneumonia (CAP) has high mortality, from 5 to 18.3%.1 Arrhythmias are a recognised significant complication. Growing evidence associates this treatable complication with increases in mortality. No review has summated data on mortality or ways to improve outcome. Aims This review aimed to define the extent of the problem, collate and appraise evidence regarding outcomes and management, and identify gaps in understanding. Methods Narrative review using a systematic protocol. Medline, ProQuest, Web of Science were searched for papers reporting adults with CAP complicated by arrhythmia. 382 articles were assessed and excluded based on title (348), abstract (27) and full text (6), leaving 11. Review of bibliographies added 3, totalling 14. These were appraised and coded, with Newcastle-Ottawa scores assigned. Results Three reviews and 11 primary studies were included: 10 Cohorts (4 prospective, 6 retrospective) and one case series. One meta-analysis of cardiac events identified a pooled incidence of 4.7% for CAP inpatients developing arrhythmia.2 N-O scores ranged from 5 to 9, Median 7.5. Outcomes reported: Incidence; 30 and 90 day mortality; Re-hospitalisation; predisposing factors. Only one paper commented on treatment. Discussion There is high quality evidence of a link between CAP and arrhythmogenesis. Data linking it to mortality suggest a strong association with worse outcome. This review was limited by its single reviewer. Some evidence was limited by retrospective study designs and biassed populations. The strengths of this review lie in its reproducible systematic methods and clear outlining of gaps in our understanding of this phenomenon, particularly regarding best management. Conclusion New arrhythmia complicating CAP is a recognised phenomenon that carries morbidity and mortality. Notably, no research has been reported on how best to manage this complication – reflected by the guidelines for the respective diseases in isolation. The next step is to look at how this complication is managed and identify the best approach to improve patient outcomes. References 1 Lim WS, Woodhead M. BTS adult CAP audit 2009/10. Thorax 2011;66(6):548–549 2 Corrales-Medina VF, et al. Cardiac complications in patients with community-acquired pneumonia: a systematic review and meta-analysis of observational studies. PLoS Med. 2011;8(6):779
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 | 0.003 | 0.011 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.004 | 0.004 |
| Bibliometrics | 0.013 | 0.015 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.006 | 0.001 |
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".