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Indian J Crit Care Med. 2017 Oct;21(10):671-677. doi: 10.4103/ijccm.IJCCM_148_17.

Dyspnea, Eosinopenia, Consolidation, Acidemia and Atrial Fibrillation Score and BAP-65 Score, Tools for Prediction of Mortality in Acute Exacerbations of Chronic Obstructive Pulmonary Disease: A Comparative Pilot Study.

Author information

1
Department of Pulmonary and Critical Care Medicine, PGIMS, Rohtak, Haryana, India.
2
Department of Obstetrics and Gynaecology, PGIMS, Rohtak, Haryana, India.

Abstract

Introduction:

Acute exacerbations of chronic obstructive pulmonary disease (AECOPD) being common and often fatal, prognostic tools in AECOPD are lacking.

Materials and Methods:

A prospective, observational study was carried out in fifty patients of AECOPD admitted in A and E department. Dyspnea, Eosinopenia, Consolidation, Acidemia and atrial Fibrillation (DECAF) score and elevated blood urea nitrogen, altered mental status, pulse >109, age >65 (BAP-65) score were calculated. Dyspnea was scored using extended Medical Research Council Dyspnoea score. Data were collected and analyzed using SPSS 17.0 software.

Results:

Forty-one patients were discharged and 9 (18%) died during treatment. Patients who were discharged and patients who died during hospital stay were compared. There was no significant difference in terms of sociodemographic variables, presence of comorbidities, and other markers of disease severity. A significant difference was found in blood counts, blood urea, serum creatinine, acidotic respiratory failure, and atrial fibrillation. A higher value of DECAF score and BAP-65 score was found more commonly in patients who died. Sensitivity for prediction of mortality for DECAF score and BAP-65 score was 100% and specificity was 34.1% and 63.4%, respectively. Sensitivity for prediction of need for invasive ventilation for DECAF score and BAP-65 score was 80% and 100%, respectively, and specificity was 80% and 60%, respectively.

Conclusion:

Both DECAF and BAP-65 scores were found to be good predictors of mortality and need for ventilation in this pilot study.

KEYWORDS:

Acute exacerbation chronic obstructive pulmonary disease; mortality; ventilation

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