Comparison of Scoring Systems for Mortality Prediction in Acute Exacerbation of Chronic Obstructive Pulmonary Disease
Journal Title: Journal of Medical Science And clinical Research - Year 2017, Vol 5, Issue 3
Abstract
Acute exacerbation of chronic obstructive pulmonary disease (AECOPD) is a frequent cause of emergency admission. A scoring system is invaluable in predicting mortality and guiding therapeutic interventions. Aims: Comparison of DECAF, BAP-65, CURB-65, CAPS, APACHE II risk scores in predicting in hospital mortality in AECOPD. Methods: 150 patients of AECOPD, admitted during ten month period were scored at admission using all 5 scores and their ability to predict in-hospital mortality was analysed. The cut off value of scores that best predicted mortality was identified. Individual parameters that correlated best with mortality were also documented. Results: DECAF score>=2, with an AUROC of 0.729, correlated best with mortality. APACHE 2 score>=18 could predict in hospital mortality with an AUROC of 0.700, CURB-65>=2 predicted mortality with an AUROC of 0.709.Parameters that were most closely associated with mortality were Altered Mentation, Respiratory rate>30/min, Hyponatremia (S.Na+ <130mEq/L, Hypoalbuminemia (<3.5g/dL) . Conclusion: DECAF score(>=2) best correlates with in hospital mortality. Individual parameters of Altered Mentation(GCS<15), Respiratory rate>30/min, Baseline dyspnoea of eMRCD 5b, Elevated WBC count (>40000), Hyponatremia (S.Na+ <130mEq/L, Hypoalbuminemia (<3.5g/dL) correlates best with mortality.
Authors and Affiliations
Dr Neethu Thambi
Fasting Blood glucose on Quality of Life with Aerobic Versus Resisted Exercises
Physical modes in the management of type II diabetic were analysed with aerobic versus resisted exercise training in this study among 150 subjects on diabetic medication. 12 weeks pre and post fasting blood sugar was rec...
A Cross-sectional Study of Road Traffic Accidents at a Tertiary Care Hospital in Jaipur City, Rajasthan
Introduction: Injuries related to road traffic accidents (RTA) contribute to significant increase of the number of trauma admissions at tertiary care centre, taking out a significant number of lives and resources. We nee...
Standard Anterior Repair of Hiatus Hernia During Laparoscopic Sleeve Gastrectomy Causes a Significant Reduction in Symptoms of GERD
Bariatric surgery is the most effective treatment for gastro-esophageal reflux disease (GERD) in obese patients. Published data reporting the results of laparoscopic sleeve gastrectomy (LSG) and hiatus hernia repair in p...
ffect of Three Irrigating Solutions on Removal of Smear Layer: A Sem Study
The success of endodontic treatment depends on the eradication of microbes from the root canal system and prevention of re-infection. The root canal is shaped with hand and rotary instruments under constant irrigation to...
Open reduction and internal fixation of talar fractures using various approaches and its outcome: A case series study
Introduction: Talus fractures are common in injuries of high-energy mechanisms and also with other musculoskeletal injuries and systemic trauma. Treating talus fracture in the multiple injured patient is a challenge. Var...