Value of the DECAF score in predicting hospital mortality in patients with acute exacerbation of chronic obstructive pulmonary disease admitted to Zagazig University Hospitals, Egypt

Background Acute exacerbation of chronic obstructive pulmonary disease (AECOPD) is a common undesirable event associated with significant morbidity and mortality. Several clinical prediction tools for predicting in-hospital mortality in patients with AECOPD have been developed in the past decades. However, some issues concerning the validity and availability of some predictors in the existing models may undermine their clinical applicability in resource-limited clinical settings. Methods We developed a multivariable model for predicting in-hospitality from a retrospective cohort of patients admitted with AECOPD to one tertiary care center in Thailand from October 2015 to September 2017. Multivariable logistic regression with fractional polynomial algorithms and cluster variance correction was used for model derivation. Results During the study period, 923 admissions from 600 patients with AECOPD were included. The in-hospital mortality rate was 1.68 per 100 admission-day. Eleven potential predictors from the univariable analysis were included in the multivariable logistic regression. The reduced model, named MAGENTA, incorporated seven final predictors: age, body temperature, mean arterial pressure, the requirement of endotracheal intubation, serum sodium, blood urea nitrogen, and serum albumin. The model discriminative ability based on the area under the receiver operating characteristic curve (AuROC) was excellent at 0.82 (95% confidence interval 0.77, 0.86), and the calibration was good. Conclusion The MAGENTA model consists of seven routinely available clinical predictors upon patient admissions. The model can be used as an assisting tool to aid clinicians in accurate risk stratification and making appropriate decisions to admit patients for intensive care.

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PROGNOSTIC UTILITY OF THE DECAF SCORE TO PREDICT IN-HOSPITAL MORTALITY AMONG PATIENTS WITH ACUTE EXACERBATION OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE ADMITTED AT CHINESE GENERAL HOSPITAL

Respirology ◽

10.1111/resp.13420_107 ◽

2018 ◽

Vol 23 ◽

pp. 128-129 ◽

Cited By ~ 1

Keyword(s):

Chronic Obstructive Pulmonary Disease ◽

Hospital Mortality ◽

General Hospital ◽

Pulmonary Disease ◽

Acute Exacerbation ◽

Chronic Obstructive ◽

Obstructive Pulmonary Disease ◽

Prognostic Utility

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Effect of Glycemic Control on Outcome of Acute Exacerbation of Chronic Obstructive Pulmonary Disease(AECOPD)

Journal of the Endocrine Society ◽

10.1210/jendso/bvab048.837 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. A411-A411

Author(s):

Abhraneel Parames Guha

Keyword(s):

Diabetes Mellitus ◽

Chronic Obstructive Pulmonary Disease ◽

Hospital Mortality ◽

Hospital Stay ◽

Pulmonary Disease ◽

Acute Exacerbation ◽

Airflow Limitation ◽

Chronic Obstructive ◽

Obstructive Pulmonary Disease ◽

Patients With Diabetes

Abstract Introduction: Chronic obstructive pulmonary disease (COPD) is defined as a common preventable and treatable disease that is characterized by persistent airflow limitation that is usually progressive and associated with an enhanced chronic inflammatory response in the airways and the lung to noxious particles or gases. In this article we compared hospital stay between diabetic, non diabetic and prediabetic patients of acute exacerbation of chronic obstructive pulmonary disease (AECOPD) who were treated with corticosteroids. We checked in hospital mortality and 30 day mortality in patients with AECOPD patients with diabetes, Its the first article on this topic from eastern India. Materials and Methods: The study was done in tertiary care centre from November 2017 to April 2019. We included 161 patients with age more than 40 years or more. Patients admitted in hospital with COPD with cough, sputum, dyspnea were included. They were divided into diabetic,prediabetic and non diabetic. We included readmission of patients who were diagnosed previously as AECOPD. Statistical Analysis was performed with help of Epi Info (TM) 7.2.2.2 EPI INFO is a trademark of the Centers for Disease Control and Prevention (CDC). It was a prospective observational study. Results: We found significant association between length of hospital stay and those with AECOPD with diabetes.29.6% of patients with diabetes had a stay of more than two weeks. Hospital stay was found to be 10.8+/-2.30 days in those who had mean random blood sugar (RBS) between 140 -170 mg/dl, 12.98 +/- 2.24 days in those who had RBS between 170–200 mg/dl and 12.62 +/- 3.10 days in those who had RBS more than 200 mg/dl. 89.4% of patient had a BMI (Body mass index) of < 25 kg/square meter. 8.1 % died in hospital and 9.5% died within 30 days of discharge. Among those who were treated with steroids, diabetic patients had a stay of 14.55+/- 0.74 days, compared to prediabetic who had a stay of 14.07+/-1.26 days and non diabetics who had 12.5+/-1.33 days. No association was found between hospital mortality and status of diabetes mellitus. No association was found between 30 day mortality and diabetes mellitus in our study. Conclusion: Diabetes Mellitus and AECOPD are major public health challenges. Whether there is an association between them needs to be addressed, specially in this part of the world. Those patients who were diabetic and treated with steroids had a longer stay than non diabetics and prediabetics. We found no association between hospital mortality and 30 day mortality with diabetes mellitus.

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Eosinopenia as a marker of outcome in acute exacerbation of chronic obstructive pulmonary disease

International Journal of Advances in Medicine ◽

10.18203/2349-3933.ijam20213639 ◽

2021 ◽

Author(s):

Sneha Biradar ◽

Balakrishna Teli ◽

Prashanth V. N.

Keyword(s):

Chronic Obstructive Pulmonary Disease ◽

Mechanical Ventilation ◽

Hospital Mortality ◽

Pulmonary Disease ◽

Acute Exacerbation ◽

Chronic Obstructive ◽

P Value ◽

Obstructive Pulmonary Disease ◽

Duration Of Hospitalization ◽

Exacerbation Of Copd

Background: Chronic obstructive pulmonary disease (COPD), the fourth leading cause of death in the world.Acute exacerbation of COPD has 10% mortality rate at admission and 1/3rd die within a year of hospitalization. Eosinopenia typically accompanies the response to acute inflammation or infection. The objective of this study was to know whether eosinopenia is an economical marker in predicting the outcome in patients hospitalized due to acute exacerbation of COPD.Methods: This is a prospective study conducted on 121 patients presenting with AECOPD satisfying inclusion and exclusion criteria admitted in hospitals attached to Bangalore Medical College and Research Institute. All necessary investigations were done. Patients with AECOPD were divided in two groups: One with eosinopenia and other without eosinopenia. Duration of hospitalization, need for mechanical ventilation and in-hospital mortality was assessed in both the groups. Results: Among 121 patients with AECOPD, 56 were eosinopenic and 65 patients were non-eosinopenic. Majority of patients belonged to age group of 51-60 years with mean age was 62.06±10.783 years. Duration of hospitalization of patients with eosinopenia was 9.04±5.18 days and that of patients without eosinopenia was 6.15±2.89 (p value<0.001). Among them, 41 (73.2%) patients with eosinopenia and 21 (32.3%) patients without eosinopenia needed mechanical ventilation (p≤0.001). In-hospital mortality rates among eosinopenic and non-eosinopenic patients were 53.6% and 15.4% respectively. Conclusions: There is a significant relationship between eosinopenia and outcomes of patients with AECOPD. Thus, eosinopenia is a useful, easy-to-measure, inexpensive biomarker for predicting the prognosis and outcome in patients with AECOPD.

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