Longitudinal Cognitive Recovery After Critical Illness: Trajectories in Sepsis and Non-Sepsis Survivors
Bibliographic record
Abstract
Background Post-critical illness cognitive dysfunction (PCICD) is a frequent and debilitating outcome among survivors of critical illness. Although sepsis has been associated with poor cognitive outcomes, its independent contribution remains unclear due to overlapping clinical factors. This study sought to characterize cognitive recovery trajectories over 12 months after intensive care. Methods In this single-center prospective cohort study, adult ICU survivors were assessed at 1, 3, 6 and 12 months post-discharge using telephone-administered Mini-Mental State Examination (MMSE) or Montreal Cognitive Assessment (MoCA-Blind). Total scores were standardized within instrument ( z- scores). Linear mixed-effects models evaluated change in z -scores over time. Domain-specific analyses examined whether any cognitive domain was disproportionately impaired. Logistic regression estimated odds of cognitive impairment adjusting for time, sepsis status, test type, age, Charlson index, peak SOFA, and benzodiazepine exposure; complete-case analyses were used. Results Of 185 eligible patients, 84 (45%) completed at least one cognitive assessment. Standardized scores improved from 1 to 3 months (+0.40 SD; 95% CI 0.02-0.78; p = 0.04) and 6 months (+0.54 SD; 95% CI 0.10-0.98; p = 0.02), with a similar but non-significant rise by 12 months (+0.49 SD; 95% CI −0.05 to 0.95; p = 0.10). Adjusted odds of impairment declined at 6 (OR 0.25, 95% CI 0.12-0.55) and 12 months (OR 0.34, 95% CI 0.14-0.85) versus 1 month; the 3-month reduction did not reach significance (OR 0.48, 95% CI 0.23-1.04). Sepsis was not associated with impairment (OR 1.49, 95% CI 0.63-3.56). No single cognitive domain showed a significant longitudinal slope. Conclusions ICU survivors show measurable cognitive recovery over the first year—most prominently by 3–6 months—with reduced odds of impairment by 6 and 12 months. Sepsis did not independently alter recovery. These findings support early post-ICU cognitive follow-up and rehabilitation within the first six months after discharge.
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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 | 0.003 |
| 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 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 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".