Extrarespiratory symptom burden in patients hospitalized for a COPD exacerbation: it’s not only about respiratory symptoms
Bibliographic record
Abstract
Background: in COPD exacerbations respiratory symptoms are usually bothersome, but extrarespiratory symptoms can also be prevalent and impact negatively on functional or health status. Methods: in 47 patients hospitalized for a COPD exacerbation between February and July 2017 in the Pulmonary Disease Clinic, Iasi, Romania, severity of extra respiratory symptoms such as anxiety, depression, lack of apetite, fatigue, pain, or drowsiness were measured with Edmonton Symptom Assessment Scale (ESAS). Each symptom was clinically significant (CS) if scored at least 4. Health status was measured with the COPD Assessment Test (CAT) and functional status with Karnofsky index(KI). Results: mean age(SD) was 68.4 (9.5) years and 38/80.8% were males. CS fatigue (CSF) was detected in 45/47(95.7%), pain (CSP) in 35/47(74.4%), lack of apetite (CSLA) in 34/47(72.3%), depression respectively in anxiety 30/47(63.8%), and drowsiness in 28/47(59.6%) of the patients. The concomitant presence of the first three most prevalent CSF, CSP and CSLA was associated with worse CAT scores 29.56 vs 26.09 p=0.006. Similarly presence of four CSs further worsened CAT 31.6 versus 25.5, p<0.001. Presence of five respectively six CSs were associated with CAT scores of 31.42 vs 25.87 p=0.001, respectively 31.42 vs 25.78 p=0.001, and with a Karnofsky index 52.14 vs 65.15, p=0.002 for six CSs. The higher the number of CS extrarespiratory symptoms, the higher the CAT score was (Spearman’s rho=0.48,p=0.001). Conclusions: in COPD patients hospitalised for an exacerbation, extrarespiratory symptoms are prevalent and associated with worse health and functional status, especially with the increase in their number.
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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 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| 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".