Relationship Between ACEF, DECAF-L, Ottawa COPD Risk Scale Scores, Laboratory Parameters, and In-Hospital Mortality in Patients Admitted to the Emergency Department with COPD

Aim: This study aimed to identify clinical and laboratory factors predicting early-term (first 10 days) mortality in patients diagnosed with chronic obstructive pulmonary disease (COPD) who were admitted after being evaluated in a tertiary emergency department. We also sought to assess the performance of the Age, Creatinine, and Ejection Fraction (ACEF), the Dyspnea, Eosinopenia, Consolidation, Acidemia, Atrial Fibrillation, and Lactate (DECAF-L), and the Ottawa COPD Risk Scale (OCRS) risk scoring systems. Materials and Methods: This prospective follow-up study conducted on 101 patients diagnosed with COPD who were admitted to the emergency department and were subsequently admitted to a ward or intensive care unit. Patients' physical examination findings, symptoms, vital signs (including consciousness level, Glasgow Coma Socore (GCS), and need for respiratory support), medical history, and respiratory support status during emergency department follow-ups were recorded. ACEF, DECAF-L, and Ottawa COPD Risk Scale scores were calculated at admission. Laboratory values at admission were also measured. Patients' mortality status was followed for 10 days. Results: Among the risk scoring systems, DECAF-L (AUC: 0.857) and the Ottawa COPD Risk Score (AUC: 0.877) demonstrated very good performance in predicting mortality, while the ACEF score (AUC: 0.772) showed moderate predictive power. In logistic regression analysis, an increase in GCS and platelet values was found to reduce mortality, whereas an increase in blood urea nitrogen and LDH values significantly increased the probability of death. Additionally, the most common causes of in-hospital deaths were identified as pneumosepsis (33.3%) and Type 1 respiratory failure (28,57%). Conclusion: As standardized risk scoring systems, DECAF-L and the Ottawa COPD Risk Score are valuable tools for rapidly and effectively assessing mortality risk in patients with COPD. These findings provide crucial information for the early recognition of mortality risk and the planning of appropriate clinical interventions in COPD patients.