[The study on the value of using the chronic obstructive pulmonary disease and asthma physiology score to assess the severity of acute exacerbation in patients with chronic obstructive pulmonary disease complicated by type II respiratory failure].

OBJECTIVE

To explore the value of the chronic obstructive pulmonary disease (COPD) and asthma physiology score (CAPS) in evaluating the severity and prognosis of patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) complicated by type II respiratory failure.

METHODS

Eighty-two cases with AECOPD complicated by type II respiratory failure between January 2005 and March 2009 were retrospectively analyzed. The severity in survivors and non-survivors was evaluated by CAPS and acute physiology and chronic health evaluation system (APACHE II score, APACHE III score), and retrospective and statistical analyses of all data were performed.

RESULTS

CAPS, APACHE II score, APACHE III score, duration of invasive positive pressure ventilation (IPPV) and days in intensive care unit of 19 cases in the death group were 34.21+/-9.89, 22.53+/-7.49, 75.11+/-18.07, (25.06+/-24.64) days, (32.42+/-25.49) days , respectively, while 63 cases of the survival group were 27.41+/-8.15, 18.65+/-5.34, 64.11+/-15.92, (5.23+/-5.50) days, (12.51+/-20.70) days, respectively, and there were significant differences between two groups (P<0.05 or P<0.01). The areas under receiver operating characteristic (ROC) curves of CAPS, APACHE II score and APACHE III score were 0.712 (P=0.005), 0.654 (P=0.043) and 0.655 (P=0.042), respectively. When CAPS score was 30.5, Youden index was the highest (0.435). The mortality rate had a positive correlation with CAPS. When the CAPS score was over 30, there was a tendency of increase in mortality rate.

CONCLUSION

CAPS is very useful to evaluate the severity and prognosis of patients with AECOPD complicated by type II respiratory failure. It is easy to perform, and better than APACHE II and APACHE III.