Utility of the DECAF Score in Patients Admitted to Emergency Department with Acute Exacerbation of Chronic Obstructive Pulmonary Disease.
10.4266/kjccm.2013.28.4.255
- Author:
Ji Hyoung SON
1
;
Jang Young LEE
;
Young Mo YANG
;
Won Young SUNG
;
Sang Won SEO
;
Jin Cheol KIM
;
Wonsuk LEE
Author Information
1. Department of Emergency Medicine, Eulji University, Daejeon, Korea. medulla@eulji.ac.kr
- Publication Type:Original Article
- Keywords:
chronic obstructive;
emergencies;
pulmonary disease
- MeSH:
Asthma;
Discrimination (Psychology);
Emergencies*;
Hospital Mortality;
Humans;
Intensive Care Units;
Intubation, Intratracheal;
Lung Diseases;
Lung Diseases, Obstructive;
Nitrogen;
Physiology;
Prognosis;
Pulmonary Disease, Chronic Obstructive*;
Respiratory Rate;
Urea
- From:The Korean Journal of Critical Care Medicine
2013;28(4):255-265
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: Exacerbations of chronic obstructive pulmonary disease (COPD) are common and can be fatal. However, it is difficult to predict the in-hospital mortality, severity and prognosis of patients. Prognostic tools are needed to assess exacerbations of COPD in the emergency department. Towards this end, we compared DECAF (dyspnea, eosinopenia, consolidation, acidemia, atrial fibrillation) score with other prognostic tools available in the emergency department. METHODS: Consecutive patients admitted to the emergency department with exacerbations of COPD were recruited. We compared the DECAF score to CAPS (chronic obstructive pulmonary disease and asthma physiology score), BAP (blood urea nitrogen, altered mental status, pulse)-65 class and CURB (confusion, urea, respiratory rate, blood pressure)-65 score and assessed in-hospital mortality, endotracheal intubation, admission to the intensive care unit and admission to the hospital. RESULTS: The in-hospital mortality rate was 4.9%. The DECAF score showed excellent discrimination for in-hospital mortality (AUROC = 0.72, p = 0.002), endotracheal intubation (AUROC = 0.92, p < 0.001), admission to the intensive care unit (AUROC = 0.90, p < 0.001) and admission to the hospital (AUROC = 0.83, p < 0.001). CONCLUSIONS: The DECAF score is a simple and effective prognostic tool for assessing cases involving exacerbation of COPD in the emergency department. Emergency physicians should consider hospital admission if the DECAF score is more than 1 and consider admission to the intensive care unit and endotracheal intubation if the DECAF score is more than 3.
