ABSTRACT
Background: Prognostic research in exacerbations of chronic obstructive pulmonary disease (COPD) requiring hospitalization has been limited and there appears to be little common ground between predictors of mortality in stable disease and during COPD. Furthermore, none of the prognostic tools developed in stable disease have been tested on hospitalised patients so this study was planned. To test dyspnoea, eosinopenia, consolidation, acidaemia, and at Objectives: rial fibrillation (DECAF) and biological assessment profile (BAP) 65 scores on patients in a tertiary care set up and validate the same. Hospital based prospective observational Methods: study was carried out in 80 patients with COPD who were admitted in Government Hospital for Chest and Communicable Diseases. DECAF and BAP-65 Scores were calculated. Data was analysed using SPSS 22 version software. In our study both DECAF score and BAP-65 score Results: performed equally well for prediction of need for Mechanical Ventilation. The AUC for need for Mechanical Ventilation was 0.75 (95% CI=0.67–0.84) for DECAF score and 0.77 (95% CI=0.67–0.85) for BAP-65 score. The AUC for prediction of mortality for DECAF score was 0.81 (95% confidence interval [CI]=0.71–0.88) and for BAP-65 score was 0.79 (95% CI=0.67–0.89). Conclusions: DECAF and BAP-65 are good and also equal in predicting mortality as well as need for mechanical ventilation.
ABSTRACT
@#Introduction: Exacerbation refers to deterioration of patient’s respiratory indications and requires a robust scoring tool for subjects suffering from Chronic Obstructive Pulmonary Disease (COPD) undergoing acute exacerbation. The Dyspnoea, Eosinopenia, Consolidation, Acidaemia, and atrial Fibrillation (DECAF) score can be utilized bedside and predicts in-hospital mortality using indices. The study aimed at assessing the prognostic standards (of duration of ICU stay, hospital stay and mortality) and the sensitivity and specificity of acute exacerbation of COPD patients based on DECAF score. Methods: This prospective study was carried out in a tertiary hospital with 84 patients between October 2016 to September 2018. On admission, DECAF score of all patients with acute exacerbation of COPD was noted and admitted to ICU. The mean duration of stay in ICU and hospital were compared. Various components of APACHE II, BAP 65, CURB 65 were also noted on admission. Results: Mean age of population was 68.29±11.80 with male predominance (68%). The study observed mortality in 6% of patients with mean ICU stay of 3.65±2.21 days and mean hospital stay of 6.45±3.28 days. For a score of 5 and 6 mean DECAF score could not be calculated as the mortality rate was 100%. ROC of DECAF score was 0.81 which was more than APACHE II (0.72) and BAP 65 (0.69) (p-value 0.07 and 0.056 suggested significance). Conclusion: The DECAF Score has been observed to be a stronger predictor for hospital mortality. Higher the DECAF score, higher is the in-hospital death rate. The DECAF score also helps in forecasting the duration of ICU stay and hospital stay.
ABSTRACT
Objective To compare the efficiency of National Early Warning Score (NEWS),Chronic Respiratory Early Warning Score(CREWS) and BAP-65(elevated Blood urea nitrogen,Altered mental status,Pulse＞109bpm,age＞65 years)among patients with AECOPD (acute exacerbations of chronic obstructive pulmonary disease).Methods Totally 181 patients with AECOPD were investigated by these three scales,and the efficiency of NEWS,CREWS and BAP-65 was compared.Results The scores of NEWS,CREWS and BAP-65 in the death group were higher than those in the survival group and the general ward group(P＜0.01).Regarding the predicted results of hospital death,the area under the ROC curve of NEWS,CREWS and BAP-65 was 0.878,0.836 and 0.774,respectively,and the differences were not statistically significant(P＞0.05);for predicted results of ICU admission,the area under the ROC curve of NEWS,CREWS and BAP-65 was 0.826,0.813 and 0.716,respectively,and the differences were not statistically significant (P＞0.05).Conclusion NEWS,CREWS and BAP-65 have satisfied predictive efficiency for prognosis,and NEWS and CREWS are much easier and faster to use.