Predicting Outcome in AECOPD: A Review of the Scoring Systems

Background: COPD is a chronic lung condition marked by episodes of worsening symptoms such as dyspnea and/ or cough and sputum production known as exacerbations (ECOPD). Patients with COPD experience higher overall morbidity and death as a result of these events. There are fewer validated measures available for patients presenting with ECOPD, despite the fact that indicators like ADO, BAED, BODE, and BODEx have successfully predicted mortality in stable COPD. In this patient population, research on BAP65 and DECAF scores has shown some promise. BAP score was built on four clinical variables and predicts mortality and requirement of invasive ventilation. DECAF score takes into account five parameters and has been found to predict outcome accurately. Over time, modified versions have been proposed including the modified DECAF and DECAF-L scores. Many authors have used the CURB-65 and APACHE II scores for predicting in-hospital mortality in ECOPD as well. Comparison between these indices has shown varied results. This review examines the major scoring systems used to predict mortality and the need for invasive ventilation, from the original BAP 65 and DECAF score to modified DECAF and DECAF-L scores and comparing their performance.

Keywords: Chronic Obstructive Pulmonary Disease; Symptom flare up; BAP65; DECAF; APACHE II; Invasive Ventilation; Mortality; Prognosis.