Comparing severity scores in exacerbations of chronic obstructive pulmonary disease.
Clin Respir J. 2018 Nov 24;:
Authors: Shafuddin E, Chang CL, Hancox RJ
INTRODUCTION: Prognostic scores help identify patients at a high risk of mortality in exacerbations of COPD. The DECAF score has been reported to perform better than other severity scores in predicting mortality from exacerbations of COPD in studies including patients with pneumonia.
OBJECTIVE: To compare the performance of DECAF with other prognostic scores: CURB-65, CRB-65, and BAP-65, in predicting 30-day mortality in patients hospitalised with exacerbations of COPD without pneumonia.
METHODS: Data from hospital admission of 423 patients from two cohorts of patients with exacerbations of COPD without consolidation on chest radiographs were used to compile the CURB-65, CRB-65, BAP-65, and DECAF scores. The performance of each prognostic score in predicting 30-day mortality was studied using receiver-operating-curve analysis.
RESULTS: Thirty-one patients (7%) died within 30 days of hospital admission. 100 patients (24%) did not have DECAF scores due to incomplete laboratory data while all 423 patients had the other scores available for analysis. All scores predicted mortality with similar areas under the receiver-operating characteristic curve (CURB-65=0.69, CRB-65=0.64, BAP-65=0.64, DECAF= 0.65, p = 0.186).
CONCLUSION: In patients hospitalised with exacerbations of COPD without pneumonia, simple clinical scores that rely on fewer laboratory measures perform at least as well as DECAF in predicting early mortality. This article is protected by copyright. All rights reserved.
PMID: 30471191 [PubMed - as supplied by publisher]