Predictors of a Paroxysm of Atrial Fibrillation Developing in Patients With Exacerbated Chronic Obstructive Pulmonary Disease
Bibliographic record
Abstract
Background: Chronic obstructive pulmonary disease (COPD) is a frequent cause of atrial fibrillation (A-fib). A paroxysm of A-fib will protract the patients’ stay at hospital and increase their lethality risk considerably. Despite extensive research done in this field, the predictors of A-fib recurrence in COPD patients have not been definitively studied. Methods: Our single-institution prospective study involved 569 patients hospitalized for COPD exacerbation. Depending on whether they developed an A-fib paroxysm while in hospital, we divided the patients into two groups: group I (the main one) was composed of 111 COPD patients whose electrocardiogram (ECG) showed an A-fib paroxysm during hospitalization, and group II (the comparison group) comprised 458 COPD patients who had no A-fib paroxysm in their entire hospitalization period. All the patients were given a comprehensive clinical, laboratory, and instrumental examination that included a complete blood count and blood chemistry test, coagulogram, room air oxygen saturation test, external respiration test, standard ECG, echocardiogram, Holter daily ECG monitoring, and a chest computed tomography (CT) scan. Results: In exacerbated COPD patients, arterial hypertension (AH) would increase their risk of developing an A-fib paroxysm by a factor of 3.74 (confidence interval (CI) 2.78 - 4.19). Arrhythmic patients’ Charlson Comorbidity Index was veritably higher (5 (3 - 6) points) than in the comparison group (3 (2 - 5) points) (P = 0.004). A-fib patients had considerably lower oxygen saturation on room air (SpO2) (91.8% (89-95%)) than non-arrhythmic patients (95.2% (91-97%)). Right atrial area enlargement would increase exacerbated COPD patients’ risk of developing an A-fib paroxysm by a factor of 1.34 (1.16 - 1.56). A-fib patients were found to have a veritably raised level of C-reactive protein to 21.0 mg/L (5.65 - 35.2 mg/L), compared to non-arrhythmic patients with 8.3 mg/L (1.31 - 16.4 mg/L). Conclusion: The development of an A-fib paroxysm in patients hospitalized for exacerbated COPD is predicted by Charlson Comorbidity Index above 4, right atrial area enlargement, and heightened C-reactive protein.
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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 | 0.001 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 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".