Prediction of outcomes in acute exacerbation of COPD with DECAF score and BAP 65 score in a rural population

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 AECOPD. Furthermore, none of the prognostic tools developed in stable disease have been tested on hospitalised patients, and most require clinical measurements not routinely available at hospital admission. This study intends to test dyspnoea, eosinopenia, consolidation, acidemia, and atrial fibrillation (DECAF) and biological assessment profile (BAP) 65 Scores on Indian patients in a tertiary care set up and validate the same to be used as a routine and effective score in predicting the outcome in AECOPD. Methods: Hospital based prospective observational study was carried out in 100 patients with AECOPD who was present to general medicine. DECAF and BAP-65 Scores were calculated. Data was analyzed using SPSS 22 version software. Results: In our study both DECAF score and BAP‑65 score performed equally well for prediction of need for Mechanical Ventilation. The AUROC for need for Mechanical Ventilation was 0.77 (95% CI=0.67–0.84) for DECAF score and 0.77 (95% CI=0.67–0.85) for BAP‑65 score. The AUROC for prediction of mortality for DECAF score was 0.83 (95% confidence interval [CI]=0.74–0.89) and for BAP‑65 score was 0.79 (95% CI=0.69–0.86). Conclusions: DECAF and BAP-65 are good and also equal in predicting mortality as well as need for mechanical ventilation. Both scores can be easily applicable in AECOPD patients, so that death during hospitalization for AECOPD and need for mechanical ventilation can be minimized.