Prajapati Amit, Sharma Yubaraj, Thapa Suman, Devkota Sadina
Department of Internal Medicine, Bhaktapur Hospital, Dudhpati, Bhaktapur, Nepal.
Department of Internal Medicine, Patan Academy of Health Sciences, Lagankhel, Lalitpur, Nepal.
JNMA J Nepal Med Assoc. 2025 Mar;63(283):144-148. doi: 10.31729/jnma.8903. Epub 2025 Mar 31.
Acute exacerbation of chronic obstructive pulmonary disease (AECOPD) can often lead to hospital admission and has the potential to be fatal. Lack of prognostic research in exacerbation requiring hospitalization that can accurately predict inhospital mortality is a challenge. This study aims to assess value of the DECAF (Dyspnea, Eosinopenia, Consolidation, Acidemia and Atrial fibrillation) score as a clinical prediction tool for inhospital mortality, need of intensive care unit (ICU) stay and risk stratification in patients with Acute exacerbation of chronic obstructive pulmonary disease.
This is an observational cross-section, hospital based study conducted from April 2022 to February 2023 at a tertiary care centre. The patients admitted with the diagnosis of acute exacerbation of chronic obstructive pulmonary disease were included in the study and their DECAF score were calculated. Patients were followed up during hospital stay and their outcome were recorded. The prognostic value of DECAF score was assessed by area under receiver operator characterstics curve.
There were 83 patients enrolled in the study out of which 13 (15.66%) died in the hospital and 20 (24.09%) required ICU stay. The area under receiver operator characteristic curve value for mortality owas 0.89 and that for intensive care unit stay was 0.84.
This study shows that DECAF score is a good predictor of inhospital mortality and ICU admission.
慢性阻塞性肺疾病急性加重（AECOPD）常常导致患者住院，且有致命风险。对于需要住院治疗的加重期患者，缺乏能够准确预测院内死亡率的预后研究是一项挑战。本研究旨在评估DECAF（呼吸困难、嗜酸性粒细胞减少、实变、酸血症和心房颤动）评分作为慢性阻塞性肺疾病急性加重患者院内死亡率、入住重症监护病房（ICU）需求及风险分层的临床预测工具的价值。
这是一项于2022年4月至2023年2月在一家三级医疗中心进行的基于医院的观察性横断面研究。纳入诊断为慢性阻塞性肺疾病急性加重的住院患者，并计算其DECAF评分。在患者住院期间进行随访并记录其结局。通过受试者工作特征曲线下面积评估DECAF评分的预后价值。
本研究共纳入83例患者，其中13例（15.66%）在医院死亡，20例（24.09%）需要入住ICU。死亡率的受试者工作特征曲线下面积值为0.89，入住重症监护病房的该值为0.84。
本研究表明，DECAF评分是院内死亡率和入住ICU的良好预测指标。
