The usefulness of the DECAF score in predicting hospital mortality in Acute Exacerbations of Chronic Obstructive Pulmonary Disease

Abstract

Background: Limited information is available about predictors of short-term outcomes in patients with exacerbation of chronic obstructive pulmonary disease (eCOPD) attending an emergency department (ED). Such information could help to stratify these patients and guide medical decision-making. The aim of this study was to develop a clinical prediction rule for in-hospital mortality of eCOPD. Methods: The study was conducted on 100 consecutive adult patients, who were admitted to the Emergency Medical Department in Alexandria Main University Hospital with the diagnosis of eCOPD. Admission clinical data and in-hospital death rates were recorded. Independent predictors of outcome were identified by logistic regression analysis and incorporated into a clinical prediction tool. Results: Most of parameters in the DECAF score (Dyspnea, Eosinopenia, Consolidation, respiratory Acidosis and atrial Fibrillation) showed a statistically significant value to the mortality; dyspnea (p = 0.001), Consolidation (p = 0.030) and respiratory Acidosis (p < 0.001). Frequency of admissions was found to be the most linked factor to mortality after eCOPD with a statistically significant value (p < 0.001). The Modified DECAF score (Dyspnea, Eosinopenia, Consolidation, respiratory Acidosis, Frequency of admissions) is more sensitive and specific in predicting in-hospital mortality in eCOPD than the DECAF score. Conclusion: The DECAF score is a powerful score to predict in-hospital mortality from eCOPD. Most of the predictors in the score make sense as to why they might predict mortality in eCOPD, meaning largely objective and reliable. The modified DECAF score is more sensitive and specific in predicting in-hospital mortality in eCOPD than the DECAF score.

Keywords

• COPD
• DECAF
• Exacerbations
• Modified DECAF
• Risk analysis