Utility of Screening for Cognitive Impairment at Hospital Discharge in Adult Survivors of Critical Illness
Bibliographic record
Abstract
BACKGROUND: Few studies have explored the utility of screening for cognitive impairment near hospital discharge in intensive care unit survivors. OBJECTIVES: To explore baseline and hospitalization characteristics associated with cognitive impairment at hospital discharge and the relationship between cognitive impairment and 6-month disability and mortality outcomes. METHODS: Hospital disability status and treatment variables were collected from 2 observational cohort studies. Patients were screened for cognitive impairment at hospital discharge using the Montreal Cognitive Assessment (MoCA)-Blind, and telephone follow-up was conducted 6 months after discharge to assess vital and physical disability status. RESULTS: Of 423 patients enrolled, 320 were alive at hospital discharge. A total of 213 patients (66.6%) were able to complete the MoCA near discharge; 47 patients (14.7%) could not complete it owing to cognitive impairment. In MoCA completers, the median (IQR) score was 17 (14-19). Older age (β per year increase, -0.09 [95% CI, -0.13 to -0.05]) and blood transfusions during hospitalization (β, -1.20 [95% CI, -2.26 to -0.14]) were associated with lower MoCA scores. At 6-month follow-up, 176 of 213 patients (82.6%) were alive, of whom 41 (23.3%) had new severe physical disabilities. Discharge MoCA score was not significantly associated with 6-month mortality (adjusted odds ratio, 1.03 [95% CI, 0.93-1.14]) but was significantly associated with risk of new severe disability at 6 months (adjusted odds ratio, 0.85 [95% CI, 0.76-0.94]). CONCLUSION: Assessing for cognitive impairment at hospital discharge may help identify intensive care unit survivors at higher risk of severe physical disabilities after critical illness.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.027 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.002 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 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 teacher head, 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".