Predicting mortality by DECAF score in exacerbations of COAH

Background and aim: Chronic obstructive pulmonary disease(COPD) is one of the most important cause of morbidity and mortality in the whole world. Acute exacerbation of chronic obstructive pulmonary disease (AECOPD) is associated with increased disease severity and mortality. In our research, we aimed to determine the predictive factors of mortality in patients with COPD exacerbation admitted to hospital. We evaluated to the DECAF score ( extended MRC score Dypspnoea score, eosinopenia, consolidation, acidemia, atrial fibrillation) which could be a predictive tool for mortality, mechanic ventilation requirement, and length of hospital stay in patients hospitalised with COPD exacerbation. Determining the risk groups according to this score, may help clinicians to plan early discharge or early ventilation support in patients. Material Method: Patients hospitalized with AECOPD were retrospectively screened in Manisa Celal Bayar University hospital. Patients with metastatic malignancies, especially who survive expectancy is 1 year or less, and patients with asthma were excluded from the study. Demographic characteristics, laboratory data, mMRC dyspnea score, FEV1 value, LTOT and NIMV use, comorbidity and complications, need for mechanical ventilation, length of hospital stay, and mortality within 30 days of discharge were recorded. Data were analyzed by chi-square test or, if necessary, by Fisher's exact and correlation tests. Results: A total of 100 cases were evaluated in our study. The mean age was 67.46 ± 8.32 years. It was seen that 5% of the patients died within the hospital and 5% died within 30 days after discharge. In-hospital mortality rate was 0% in the low-risk group with a score of 0-1 and in the middle-risk group with a score of 2 according to the DECAF score, while the mortality rate was significantly increased in patients with score of 3 or more. However, the need for IMV increased in this group and NIMV requirement decreased in the same patients. The duration of hospitalization was significantly increased in patients with 5 score compared to the other groups. When the data used in this score were evaluated independently, it was seen that increased mMRC dyspnea score and the presence of AF were associated with the increased mortality risk. Conclusions: The most important result in our study; DECAF score may be used as a good prognostic marker in patients present with AECOPD. Although there is not enough data yet, studies performed until now on this subject support our findings.