Chest
Original ResearchObstructive Lung DiseasesValidation of a Novel Risk Score for Severity of Illness in Acute Exacerbations of COPD
Section snippets
Data Source
We used one of the clinical research databases from CareFusion (Clinical Research Services, CareFusion; Marlborough, Massachusetts) for the period from January 1, 2007, through December 31, 2007. This database records input from 177 hospitals on all acutecare admissions. Specifically, the database contains information concerning patient demographics, discharge diagnoses, length of stay, hospital charges, and hospital mortality. It also includes patient vital signs and results from laboratory
Results
The final cohort included 34,669 subjects, of whom 80.6% had a principal diagnosis of AECOPD and the remainder had acute respiratory failure noted as the principal diagnosis along with COPD as a secondary diagnosis. As shown in Table 1, the median age was 72 years and 46.4% were men. The most common comorbidities were hypertension, congestive heart failure, and diabetes mellitus.
Approximately 4% of patients died while in the hospital, and MV was required at any point in 9.2%. We observed the
Discussion
This analysis of a large cohort of patients with AECOPDs demonstrates that the BAP-65 class correlates well with multiple clinical outcomes ranging from in-hospital mortality and need for MV to LOS and cost. Furthermore, the BAP-65 system identifies subjects unlikely to ever need MV. Given that clinical decision making along with determinations as to the triage of patients is a complex process that requires an analysis of multiple factors beyond just severity of illness, the ability of BAP-65
Acknowledgments
Author contributions: Dr Tabak had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.
Dr Shorr: contributed to study concept and design, analysis and interpretation of data, drafting and critical revision of the manuscript for important intellectual content, statistical expertise, and study supervision.
Dr Sun: contributed to study concept and design; acquisition, analysis, and interpretation of data; critical
References (14)
- et al.
Contemporary management of acute exacerbations of COPD: a systematic review and metaanalysis
Chest
(2008) - et al.
The economic burden of COPD
Chest
(2000) Trends in COPD (chronic bronchitis and emphysema): morbidity and mortality. American Lung Association Web site
- et al.
Chronic obstructive pulmonary disease surveillance—United States, 1971-2000
MMWR Surveill Summ
(2002) - et al.
Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease: GOLD executive summary
Am J Respir Crit Care Med
(2007) - et al.
Susceptibility to exacerbation in chronic obstructive pulmonary disease
N Engl J Med
(2010) - et al.
A prediction rule to identify low-risk patients with community-acquired pneumonia
N Engl J Med
(1997)
Cited by (69)
Decrease in Readmissions after Hospitalisation for COPD Exacerbation through a Home Care Model
2022, Open Respiratory ArchivesCitation Excerpt :More than 50% of these patients were ex-smokers (mean of 63.8 pack-years), 58.7% had one or more cardiovascular comorbidities, and 9% were diagnosed with bacterial colonisation. In the 12 months preceding their hospitalisation, the mean number of episodes of COPDE per patient was 2.16 (mean length of hospital stay of 7.14 days, and moderate severity according to the BAP-657 and DeCOPD8 classifications). In the total study population, 23.5% of the patients were readmitted within the first 30 days after their discharge from the hospital and 37.4% of them within the first 90 days, with a pooled one-year survival rate of 84.3% (Table 3).
The prognostic factors of in-hospital death among patients with pneumonic COPD acute exacerbation
2022, Respiratory InvestigationSpanish COPD Guidelines (GesEPOC) 2021 Update Diagnosis and Treatment of COPD Exacerbation Syndrome
2022, Archivos de BronconeumologiaThe role of the BUN/albumin ratio in predicting mortality in COVID-19 patients in the emergency department
2021, American Journal of Emergency MedicineCitation Excerpt :It is a parameter of the scoring system called CURB-65, which is used especially in pneumonia patients [8]. It has been shown that its level is higher in pneumonia [9], chronic obstructive pulmonary disease [10], pancreatitis [11], acute myocardial infarction [12], heart failure [13], sepsis [14], and geriatric patients [15] with mortality. There have also been studies that showed a higher BUN level in COVID-19 patients with mortality [16].
Funding/Support: The authors have reported to CHEST that no funding was received for this study.
Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (http://www.chestpubs.org/site/misc/reprints.xhtml).