Mortality and acute exacerbation of COPD: a pilot study on the influence of myocardial injury
Bibliographic record
Abstract
Acute exacerbations of chronic obstructive pulmonary disease (COPD) punctuate important disease progression [1]. In-hospital mortality rates for acute exacerbations of COPD vary between 2.5% to 24.5% [2–4]. An integrated clinical score, CURB-65, has been proposed to predict in-hospital and 30-day mortality in acute exacerbations of COPD [5, 6]. According to death-certificate data the most common proximate cause of death in COPD is cardiac disease [7]. An association between elevated cardiac high-sensitivity troponin (hs-cTn) at admission and mortality has been reported in acute exacerbations of COPD [8, 9]. Copeptin has also been associated with poor clinical outcomes and mortality of acute exacerbations of COPD [10], as well as pneumonia [11] and myocardial infarction [12]. Recently, the combination of elevated copeptin and hs-cTn at admission for acute chest pain has been shown to have better discriminative value for acute myocardial injury [13] than troponin alone, as well as strong prognostic value for major cardiac adverse events [14]. We hypothesised that myocardial injury may be an important cause of death in patients admitted with an acute exacerbations of COPD. Accordingly, we investigated whether circulating markers of myocardial injury at the time of presentation to the emergency department (ED) with acute exacerbations of COPD added prognostic value to the CURB-65 score. Acute exacerbated COPD patients with elevated markers of myocardial injury are at high risk of early mortality
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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 | 0.003 | 0.003 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 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".