Decaf Score in Predicting Prognosis of Acute Exacerbation of Copd in Patient Required Hospital and ICU Admission

Abstract

Introduction: Exacerbation refers to deterioration of patient’s respiratory indications and requires a robust scoring tool for subjects suffering from Chronic Obstructive Pulmonary Disease (COPD) undergoing acute exacerbation. The Dyspnoea, Eosinopenia,Consolidation, Acidaemia, and atrial Fibrillation (DECAF) score can be utilized bedside and predicts in-hospital mortality using indices.The study aimed at assessing the prognostic standards (of duration of ICU stay, hospital stay and mortality) and the sensitivity andspecificity of acute exacerbation of COPD patients based on DECAF score. Methods: This prospective study was carried out in atertiary hospital with 84 patients between October 2016 to September 2018. On admission, DECAF score of all patients with acuteexacerbation of COPD was noted and admitted to ICU. The mean duration of stay in ICU and hospital were compared. Variouscomponents of APACHE II, BAP 65, CURB 65 were also noted on admission. Results: Mean age of population was 68.29±11.80 with male predominance (68%). The study observed mortality in 6% of patients with mean ICU stay of 3.65±2.21 days and mean hospitalstay of 6.45±3.28 days. For a score of 5 and 6 mean DECAF score could not be calculated as the mortality rate was 100%. ROC ofDECAF score was 0.81 which was more than APACHE II (0.72) and BAP 65 (0.69) (p-value 0.07 and 0.056 suggested significance).Conclusion: The DECAF Score has been observed to be a stronger predictor for hospital mortality. Higher the DECAF score, higher isthe in-hospital death rate. The DECAF score also helps in forecasting the duration of ICU stay and hospital stay.