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A5039 - Validity CURB 65, BAP 65, DECAF for Predicting Outcomes in Exacerbation of COPD
Author Block: A. R. Bastidas1, G. Hincapie Diaz2, B. Mantilla Cardozo3, C. Ramírez Sierra3, T. Valencia Castaño3; 1Medicine, University of Sabana, Chía, Colombia, 2Pneumology, Hospital Militar Central, Bogota D.C., Colombia, 3Medicine, Hospital Militar Central, Bogotá, Colombia.
Validity CURB-65, BAP-65, DECAF for Predicting Outcomes in Exacerbation of COPD. G.A. Hincapie Díaz, Mantilla Cardozo B.M, A.R. Bastidas Goyes, Ramírez Sierra C.A, Valencia Castaño T.G. Corresponding autor`s email: alirio.bastidas@clinicaunisabana.edu.co, alirio.bastidas@unisabana.edu.co, aliriorodrigo@yahoo.com Rationale: The exacerbation acute of chronic obstructive pulmonary disease (EACOPD) is a frequent complication. Mechanical ventilation, admission to intensive care unit and readmission are important outcomes in the treatment. However, there are few information about prognostic tools related with this outcomes. Objective: We aimed to validate the DECAF, BAP-65, CURB-65 scores, ant to compare its performance between then. Methods: A prospective cohort with analysis diagnostic test with 462 subjects was implemented, the database was build using variables of DECAF, BAP-65 and CURB-65 scores. All patients that arrived at emergency service of Military Hospital with diagnosis EACOPD were included until reach size sample, outcomes of mortality 7 and 30 days, requirement of mechanical ventilation, admission ICU and readmission within 30 days were evaluated. The validity of scores were realized with sensitivity (S), specificity (E), likelihood ratio (LR), and area under the receiver operator characteristic (AUROC). Results: Mean age was 79(DS:8,3) years, 50,4% were female, mortality 2,4%, outcome 7 days mortality the DECAF AUROC was 0,77, S:48%, E:16,6%, LR+3,1, LR-:0,58, BAP-65 AUROC curve 0,72, S:67,1%, E:66,7%, LR+:2, LR-:0,49, CURB-65 AUROC curve 0,65, S:53,6%, E:75%, LR+:2,14, LR-:0,61, 30 days mortality the DECAF AUROC was 0,75, S:77,8%, E:52,9%, LR+:1,65, LR-:0,42, BAP-65 AUROC 0,66, S:55,6%, E:67,6%, LR+:1,71, LR-:0,65, mechanical ventilation the DECAF AUROC was 0,75, S:78,8%, E:56%, LR+1,79, LR-0,37, BAP-65 AUROC 0,61, S:50%, E:68,9%, LR+:1,6, LR-:0,72, CURB-65 AUROC 0,59, S:59,1%, E:54,8%, LR+:1,3, LR-0,74, admission ICU DECAF AUROC was 0,74, S:78,1%, E:55,8%, LR+:1,76, LR-:0,39, BAP-65 AUROC 0,59, S:48,4%, E:68,6%, LR+:1,54, LR-:0,75, CURB-65 AUROC 0,58, S:57,8%, E:54,5%, LR+:1,3, LR-0,77, readmission within 30 days DECAF AUROC was 0,48, S:44,8%, E:50,5%, LR+:0,41, LR-:0,55, BAP-65 AUROC 0,51, S:34,5%, E:66,3%, LR+:1,02, LR-0,98, CURB-65 AUROC 0,59, S:63,8%, E:55,2%, LR+:1,42, LR-:0,65. The cutoff point to the DECAF score was of 2, to the BAP 65 was 3 and to the CURB 65 was 2. Conclusion: DECAF is the better predictor of mortality, mechanical ventilation and admission ICU, none of the scores (DECAF, BAP-65 and CURB-65) evaluated show good performance for readmission within 30 days. Additional studies are required in order to find prognostic factors associated with readmission.