Which one is superior in predicting 30 and 90 days mortality after COPD exacerbation: DECAF, CURB-65, PSI, BAP-65,
Mine Gayaf1, Gülistan Karadeniz1, Filiz Güldaval1
1Dr Suat Seren Chest Disease and Surgery Training and Research Hospital, Pulmonary Disease, University of Health Sciencies, Izmir, Turkey.
Insights
The CURB-65 score effectively predicts 30- and 90-day mortality in patients hospitalized with Chronic Obstructive Pulmonary Disease (COPD) exacerbations, proving superior to other common scoring systems for these outcomes.
Area of Science:
- Pulmonary Medicine
- Critical Care Medicine
- Medical Scoring Systems
Background:
- Chronic Obstructive Pulmonary Disease (COPD) exacerbations are associated with significant mortality.
- Several scoring systems, including DECAF, CURB-65, PSI, and BAP-65, are used to predict mortality after COPD exacerbations.
Purpose of the Study:
- To compare the predictive accuracy of DECAF, CURB-65, PSI, and BAP-65 scores for 30- and 90-day mortality in hospitalized COPD exacerbation patients.
Main Methods:
- Prospective data collection from 141 patients hospitalized with COPD exacerbation between January 2018 and March 2019.
- Analysis of demographic, clinical, laboratory parameters, and established mortality scoring systems (DECAF, CURB-65, PSI, BAP-65).
Main Results:
- Higher age, mMRC dyspnea score, pleural effusion, NLR, PLR, AF, and PaCO2 were associated with increased 30- and 90-day mortality.
- DECAF, CURB-65, PSI, and BAP-65 scores were significantly higher in deceased patients.
- The CURB-65 score demonstrated superior predictive ability for both 30-day (OR 2.968) and 90-day (OR 2.284) mortality compared to other scores.
Conclusions:
- The CURB-65 score is a simple, feasible, and significant tool for predicting short-term mortality in COPD exacerbation.
- Routine use of the CURB-65 score is recommended for all hospitalized COPD exacerbation patients to aid in mortality risk assessment.
Abstract:
Objectives: The major scores associated with the mortality after COPD exacerbations were; DECAF, CURB-65, PSI and BAP-65 scores. We aimed to compare these scores in predicting 30- and 90-day mortality in patients hospitalized with exacerbation of COPD.Methods: The data of 141 patients who were hospitalized with the diagnosis of COPD exacerbation between January 2018 and March 2019 and accepted to participate in the study were prospectively recorded.Results: Age, mean modified-medical-research-council (mMRC) dyspnea score, pleural effusion, neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), presence of atrial fibrillation (AF), PaCO2 pressure values were found to be significantly higher at both 30 and 90-days deceased group, while hemoglobin, albumin and pH values were significantly lower (all p < 0.05). DECAF, CURB-65, PSI and BAP-65 scores were significantly higher for both 30 and 90-days mortality (all p < 0.05). DECAF, CURB-65, PSI, BAP-65 scores, PLR, NLR predicted to 30 day and 90 day mortality. But, CURB-65 found (OR 2.968 and 2.284, respectively) superior to others in predicting 30 and 90-days mortality.Conclusions: CURB-65 score is a significant, simple and feasible score for predicting 30 and 90 days mortality in COPD exacerbation and may be routinely used in all patients hospitalized with COPD exacerbation.
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