A risk stratification tool for exacerbations of COPD: time to switch to DECAF

Costello, Richard W.; Cushen, Breda

doi:10.1136/thoraxjnl-2015-208053

Cited by 2 publications

(4 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Examination of prognostic scores can contribute to clinical management, early risk stratification and the prevention of poor outcomes, as well as monitoring during treatment. 47 Clinicians are constantly seeking predictors of mortality for patients with AECOPD. As a promising predictor, DECAF scores can be used in a variety of hospital settings to accurately stratify mortality risk.…”

Section: Discussionmentioning

confidence: 99%

DECAF score as a mortality predictor for acute exacerbation of chronic obstructive pulmonary disease: a systematic review and meta-analysis

Huang

Xiong

et al. 2020

BMJ Open

View full text Add to dashboard Cite

ObjectivesThis study was conducted to assess the association between the Dyspnea, Eosinopenia, Consolidation, Acidemia and Atrial Fibrillation (DECAF) scores and the prognosis of patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD), to evaluate the specific predictive and prognostic value of DECAF scores and to explore the effectiveness of different cut-off values in risk stratification of patients with AECOPD.DesignSystematic review and meta-analysis.ParticipantsAdult patients diagnosed with AECOPD (over 18 years of age).Primary and secondary outcome measuresElectronic databases, including the Cochrane Library, PubMed, the Embase and the WOS, and the reference lists in related articles were searched for studies published up to September 2019. The identified studies reported the prognostic value of DECAF scores in patients with AECOPD.ResultsSeventeen studies involving 8329 participants were included in the study. Quantitative analysis demonstrated that elevated DECAF scores were associated with high mortality risk (weighted mean difference=1.87; 95% CI 1.19 to 2.56). In the accuracy analysis, DECAF scores showed good prognostic accuracy for both in-hospital and 30-day mortality (area under the receiver operating characteristic curve: 0.83 (0.79–0.86) and 0.79 (0.76–0.83), respectively). When the prognostic value was compared with that of other scoring systems, DECAF scores showed better prognostic accuracy and stable clinical values than the modified DECAF; COPD and Asthma Physiology Score; BUN, Altered mental status, Pulse and age >65; Confusion, Urea, Respiratory Rate, Blood pressure and age >65; or Acute Physiology and Chronic Health Evaluation II scores.ConclusionThe DECAF score is an effective and feasible predictor for short-term mortality. As a specific and easily scored predictor for patients with AECOPD, DECAF score is superior to other prognostic scores. The DECAF score can correctly identify most patients with AECOPD as low risk, and with the increase of cut-off value, the risk stratification of DECAF score in high-risk population increases significantly.

show abstract

Section: Discussionmentioning

confidence: 99%

DECAF score as a mortality predictor for acute exacerbation of chronic obstructive pulmonary disease: a systematic review and meta-analysis

Huang

Xiong

et al. 2020

BMJ Open

View full text Add to dashboard Cite

show abstract

“…Subsequently, other prognostic scoring systems for in‐hospital mortality in patients with AECOPD have been developed, but their simplicity and/or predictive value were not superior to the DECAF score. Thus, the DECAF score may be the “ideal” score for predicting in‐hospital mortality in patients with AECOPD . However, the study population in which the score was developed only included eight patients requiring IMV, and the ability of the DECAF score to predict outcomes in AECOPD patients requiring IMV remains unclear.…”

Section: Discussionmentioning

confidence: 99%

“…Thus, the DECAF score may be the "ideal" score for predicting in-hospital mortality in patients with AECOPD. [3][4][5] However, the study population in which the score was developed only included eight patients requiring IMV, 3,6 and the ability of the DECAF score to predict outcomes in AECOPD patients requiring IMV remains unclear.…”

Section: Discussionmentioning

confidence: 99%

“…The Dyspnoea, Eosinopenia, Consolidation, Acidaemia and atrial Fibrillation (DECAF) score is a simple and effective predictor of mortality in patients hospitalized with AECOPD . The DECAF score has internal and external validity and is an appropriate prognostic score for AECOPD in clinical practice . However, the study population in which the score was developed only included eight patients requiring IMV; therefore, the predictive value of the DECAF score in patients with AECOPD complicated by ARF who require IMV remains to be elucidated.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

The v‐DECAF score can predict 90‐day all‐cause mortality in patients with COPD exacerbation requiring invasive mechanical ventilation

Shi

Sheng

Nian

et al. 2019

Clinical Respiratory J

View full text Add to dashboard Cite

Introduction The DECAF score is a simple and effective tool for predicting mortality in patients hospitalized with acute exacerbations of chronic obstructive pulmonary disease (AECOPD); however, the DECAF score has not been validated in AECOPD patients requiring invasive mechanical ventilation (IMV). We devised the ventilator (v)‐DECAF score, in which “anemia” replaces “acidaemia,” for use in AECOPD patients requiring IMV. The objective of this study was to compare the predictive efficacy of the v‐DECAF score and the DECAF score. Methods This study prospectively recruited 112 consecutive AECOPD patients requiring IMV from a single center. The clinical endpoint was 90‐day all‐cause mortality. Demographic and clinical data were recorded, as well as APACHE II, GCS, CURB‐65, BAP‐65 and DECAF scores, and the newly devised v‐DECAF score. The discriminatory value of the scoring systems in predicting 90‐day all‐cause mortality was determined using the area under the receiver operating characteristic (AUROC) curve. Results In multivariate logistic regression analysis, the v‐DECAF score was an independent predictor of 90‐day all‐cause mortality (odds ratio 3.004, 95% CI 1.658‐5.445, P < 0.001). The AUROC of the v‐DECAF and DECAF scores were 0.852 (95% CI 0.766‐0.938) and 0.777 (95%CI: 0.676‐0.878), respectively. The v‐DECAF score had a better predictive value for 90‐day all‐cause mortality compared to the DECAF score (Z = 2.338, P = 0.019). Conclusion The v‐DECAF score had good discriminatory power in predicting 90‐day all‐cause mortality in AECOPD patients requiring IMV.

show abstract

A risk stratification tool for exacerbations of COPD: time to switch to DECAF

Cited by 2 publications

References 15 publications

DECAF score as a mortality predictor for acute exacerbation of chronic obstructive pulmonary disease: a systematic review and meta-analysis

DECAF score as a mortality predictor for acute exacerbation of chronic obstructive pulmonary disease: a systematic review and meta-analysis

The v‐DECAF score can predict 90‐day all‐cause mortality in patients with COPD exacerbation requiring invasive mechanical ventilation

Contact Info

Product

Resources

About