DECAF_score_COPD v.1
The interpretation of DECAF score to predict in-hospital mortality risk for patient with acute exacerbation of COPD.
To provide interpretation in using DECAF score to predict in-hospital mortality risk.
Can be used in patients hospitalized with a primary diagnosis of acute exacerbation of COPD within the following criteria of patient: - ≥35 years old, - ≥10 pack-year smoking history - with or without pneumonia, and - preadmission evidence of airflow obstruction on spirometry (FEV₁/FVC <0.70). The score is calculated based on the severity of the symptom measured using the Extended MRC (eMRC) Dyspnea Scale and the presence or absence of these findings in the initial examination at the time of admission: - Eosinopenia (Eosinophils <0.05×10⁹/L) - Acidemia (pH <7.30) - Consolidation on Chest X-Ray - Atrial fibrillation on the ECG and/or a history of paroxysmal atrial fibrillation The interpretation of the score are as follow: - Low risk (score 0-1) patients may be appropriate for early supported discharge. - High risk (score 3-6) patients may be appropriate for higher levels of care and/or addressing goals of care. Higher scores may correlate with increased length of stay.
Not to be used in the following conditions: - patients with comorbidity expected to limit survival <12 months, or - patients with supplementary O₂ at home.
1. Steer J, Gibson J, Bourke SC. The DECAF Score: predicting hospital mortality in exacerbations of chronic obstructive pulmonary disease. Thorax. 2012;67(11):970-6. 2. Echevarria C, Steer J, Heslop-marshall K, et al. Validation of the DECAF score to predict hospital mortality in acute exacerbations of COPD. Thorax. 2016;71(2):133-40. 3. Steer J, Norman EM, Afolabi OA, Gibson GJ, Bourke SC. Dyspnoea severity and pneumonia as predictors of in-hospital mortality and early readmission in acute exacerbations of COPD. Thorax [Internet]. 2012;67(2):117–21. Available from: http://thorax.bmj.com/content/67/2/117.full.pdf
OBSERVATION.extended_mrc_emrc_dyspnea_scale.v0, OBSERVATION.lab_test-full_blood_count.v1, OBSERVATION.lab_test-blood_gases.v1, OBSERVATION.decaf_score_copd.v0, EVALUATION.decaf_score_copd.v0
