Assessment and comparison of APACHE II (Acute Physiology and Chronic Health Evaluation), SOFA (Sequential Organ Failure Assessment) score and CURB 65 (Confusion; Urea; Respiratory Rate; Blood Pressure), for prediction of inpatient mortality in Acute Exacerbation of Chronic Obstructive Pulmonary Disease.

OBJECTIVE

To assess and compare the role of Acute Physiology and Chronic Health Evaluation, Sequential Organ Failure Assessment, and Confusion Urea Respiratory Rate Blood Pressure scores in predicting inpatient mortality for patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease..

DESIGN

The retrospective study was conducted at the Jinnah Post-graduate Medical Centre, Karachi, and comprised data of all consecutive Acute Exacerbation of Chronic Obstructive Pulmonary Disease patients from December 1, 2013, to December 31, 2014. Logistic regression model and non-parametric tests were employed using SPSS 22..

RESULTS

There were 95 patients whose medical records were studied. The overall mean age was 60.79±12.39 years. Mortality rate was of 26(27.6%). Median hospital stay was 11.5 days (interquartile range: 9-17 days) in survivors and 4 days (2-8 days) in non-survivors. Out of the three scales used, Confusion Urea Respiratory Rate Blood Pressure-65 score showed the greatest difference between survivors and non-survivors (p <0.05). Significant higher scores were observed in non survivors with Type 2 than Type 1 respiratory failure (p<0.05). There was significant association of mortality with baseline partial pressure of oxygen and oxygen saturation (p<0.05 each).

CONCLUSIONS

Confusion Urea Respiratory Rate Blood Pressure-65score determined at the time of admission had significant ability to predict inpatient mortality..