Title: Comparison of Scoring Systems for Mortality Prediction in Acute Exacerbation of Chronic Obstructive Pulmonary Disease
Authors: Dr Neethu Thambi, Dr K V Padmanabhan, Dr Manoj D K, Dr Rajani M.
DOI: https://dx.doi.org/10.18535/jmscr/v5i3.130
Abstract
Acute exacerbation of chronic obstructive pulmonary disease (AECOPD) is a frequent cause of emergency admission. A scoring system is invaluable in predicting mortality and guiding therapeutic interventions.
Aims: Comparison of DECAF, BAP-65, CURB-65, CAPS, APACHE II risk scores in predicting in hospital mortality in AECOPD.
Methods: 150 patients of AECOPD, admitted during ten month period were scored at admission using all 5 scores and their ability to predict in-hospital mortality was analysed. The cut off value of scores that best predicted mortality was identified. Individual parameters that correlated best with mortality were also documented.
Results: DECAF score>=2, with an AUROC of 0.729, correlated best with mortality. APACHE 2 score>=18 could predict in hospital mortality with an AUROC of 0.700, CURB-65>=2 predicted mortality with an AUROC of 0.709.Parameters that were most closely associated with mortality were Altered Mentation, Respiratory rate>30/min, Hyponatremia (S.Na+ <130mEq/L, Hypoalbuminemia (<3.5g/dL) .
Conclusion: DECAF score(>=2) best correlates with in hospital mortality. Individual parameters of Altered Mentation(GCS<15), Respiratory rate>30/min, Baseline dyspnoea of eMRCD 5b, Elevated WBC count (>40000), Hyponatremia (S.Na+ <130mEq/L, Hypoalbuminemia (<3.5g/dL) correlates best with mortality.
Keywords: acute exacerbation, COPD, DECAF, CAPS, APACHE II, CURB 65, BAP.
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