Comparison of ottawa COPD risk scale (OCRS) and decaf score for short-term prognosis estimation in patient with COPD exacerbation in the emergency department

Introduction: We aimed to compare the sensitivity and specificity of the Ottawa COPD risk scale and DECAF score to estimate the short-term prognosis of COPD exacerbations in patients presenting with dyspnea. Materials and Methods: In this prospective cross-sectional study, COPD exacerbation patients who applied to our emergency department between October 2019 and April 2020 were included who did not meet the exclusion criteria. The demographic data of the patients, histories related to the disease, vital signs of arrival, the number of admissions to the emergency department due to exacerbation in the last 1 year, hospitalization, intubation, or noninvasive ventilation histories were recorded. Patients were followed up within the next 14 days, and poor discharge after discharge (re-admission to the emergency room, need for mechanical ventilation at the first admission or hospital> 14 days of hospi-talization or death) and survival in 30 days were recorded. OCRS and DECAF scores of the patients were calculated and compared in terms of predictions of poor outcome and survival. Results: During the study, a total of 385 patients applied for COPD exacerbation, 300 patients were included in the study after the patients who met the criteria for exclusion were excluded. Poor outco-mes developed in 20.7% of patients. In terms of poor outcome, if the score is below two in OCRS, sensitivity is 82.3%, specificity is 56.7% (95% CI: 50.2-63.1); In patients with less than three DE-CAF scores, the sensitivity was 69.3% (95% CI: 56.4-80.4) and the specificity was 74.8% (95% CI: 68.8-80.2). When evaluated for poor outcomes among the patients discharged from the hospital; In patients with OCRS total score below two, the sensitivity of OCRS was 66.7% (95% CI; 41.0-86.7), and specificity was 59.7% (95% CI; 52.7-66.5), In patients with a DECAF score below three, the sensitivity of the DECAF score was 33.3% (95% CI; 13.3-59.0), and the specificity was 92.7% (95% CI; 88.2-95.8). Conclusions: In terms of determining the poor outcome in COPD exacerbation patients, the sensiti-vity of OCRS was found to be better than the DECAF score, but with low specificity. In contrast, the DECAF score was found to be better in predicting mortality. Although the specificity of OCRS was low in patients discharged from the emergency department, it was determined that the sensitivity was quite high. For this reason, OCRS can be used to assess the possible risks of patients with COPD exacerbation patients in the emergency room discharge.