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 common and debilitating condition affecting survivors of critical illness. While sepsis has been implicated in poor cognitive outcomes, its independent contribution remains unclear due to multiple associated confounders in critical illness. This study aimed to characterize cognitive recovery trajectories over 12 months post-intensive care unit (ICU) and to evaluate the influence of sepsis and benzodiazepine exposure on cognitive outcomes. Methods: -scores for comparability. Mixed-effects models assessed changes over time and the effects of clinical covariates, including sepsis status and benzodiazepine exposure. Additionally, we investigated whether any one specific cognitive domain was disproportionally impaired by critical illness over time. Results: Of 197 eligible patients during the enrollment period, 77 (39%) completed at least one cognitive assessment. Standardized cognitive scores significantly improved over time, with the greatest gains observed within 6 months: +0.40 SD at 3 months (p = 0.041), +0.54 SD at 6 months (p = 0.016), and +0.49 SD at 12 months (p = 0.033) compared to scores at the time of acute illness. Sepsis status had no significant effect on recovery trajectory. No single cognitive domain was disproportionately affected by critical illness; instead, changes were observed in the overall score over time. Benzodiazepine exposure showed complex associations: longer duration (-0.24 SD/day, p = 0.008) and higher daily dose (-0.02 SD/unit, p = 0.006) were linked to worse cognition, while total cumulative dose was paradoxically associated with better scores (+0.03 SD/unit, p < 0.001), possibly reflecting confounding by indication or survival bias. Conclusions: ICU survivors experience gradual cognitive recovery over the first year, primarily within 6 months. Sepsis does not independently affect this trajectory. Benzodiazepine exposure, especially prolonged or high daily dosing, emerges as a modifiable risk factor for cognitive impairment, consistent with prior investigations of PCICD. These findings highlight the importance of sedation strategies and structured cognitive follow-up.
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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".