Comparison of integrated pulmonary index, ottawa copd risk scale and early warning scoreo₂ of short term serious outcomes in COPD patients

Objective: Chronic Obstructive Pulmonary Disease (COPD) patients who were evaluated in the emergency department with a pre-diagnosis of COPD exacerbation by comparing Integrated Pulmonary Index (IPI), Ottawa COPD Risk Scale (OCRS), National Early Warning Score2 (NEWS2) and Early Warning ScoreO₂ (EWS.O₂), to what extent the scores predicted safe discharge, high-risk patients and short-term poor outcomes were investigated. Methods: It was designed as a prospective observational study. Patients with a diagnosis of COPD were included in the Emergency Medicine Clinic of Aydın Adnan Menderes University Hospital between 01.06.20 and 01.12.20. Patients at risk due to the Covid-19 pandemic were excluded from the study. The IPI, OCRS, NEWS2 and EWS.O₂ scores of the patients were recorded in the case form and the short-term serious outcomes were analyzed. Serious outcomes was defined as death within 30 days after emergency service admission, admission to intensive care unit within 14 days, need for endotracheal intubation or non-invasive ventilation, diagnosis of myocardial infarction and re-admission to the emergency department with COPD exacerbation. Results: 144 patients were included in the study. The most common outcome diagnosis of the patients in the emergency department was COPD exacerbation (41.6%). 84% of the patients in the study had serious outcome criteria in the short term. Among these, it was observed that 44.3% of the patients who were discharged applied to the emergency department again with COPD exacerbation. When the scores were examined as discharge from the emergency service and admission to the intensive care unit, a statistically significant difference was found between the groups (p <0.001). As a short term poor outcome; when deaths within 30 days and admission to intensive care unit were examined, the scores were significant (p <0.001). Conclusion: In emergency services, especially in critical patient care such as COPD, the presence of devices that automatically display a new scoring EWS.O₂ can help physicians to make decisions. Scores are consistent with each other in safe discharge and separation of high-risk patients. We believe that these scores will guide future studies. Key words: Emergency Medicine, Chronic Obstructive Pulmonary Disease, Integrated Pulmonary Index, Ottawa COPD Risk Scale, Early Warning ScoreO₂, National Early Warning Score 2