A STUDY TO VALIDATE THE DECAF SCORE FOR PREDICTING CLINICAL OUTCOMES IN ACUTE EXACERBATION OF COPD AT A TERTIARY CARE HOSPITAL

Dr. Banda Naveen*, Dr. Hari Prasad S. and Dr. G. S. Ramya

ABSTRACT

Introduction: Chronic obstructive pulmonary disease (COPD) is a common lung disease causing restricted airflow and breathing problems. In people with COPD, the lungs can get damaged or clogged with phlegm. Symptoms include cough, sometimes with phlegm, difficulty breathing, wheezing and tiredness. The Dyspnoea, Eosinopenia, Consolidation, Acidaemia, and atrial Fibrillation (DECAF) score was derived in a large cohort of consecutive patients hospitalised with AECOPD, is simple to apply at the bedside and predicts inhospital mortality using indices routinely available on admission. The aim of the study was to validate the DECAF score at admission as a tool to predict the clinical outcome of the patients during hospitalization for AE-COPD. Aim and Objective:
1) To validate DECAF score as a tool to predict the clinical outcome of the patients during hospitalization for acute exacerbation of COPD.
2) To study the association between DECAF score and outcome variables like mechanical ventilation and duration of hospital stay.
Materials and methods: This study was conducted as a prospective, cross-sectional observational study at a tertiary care center in South India from April 2023 to March 2024. Patients were enrolled based on defined inclusion and exclusion criteria. Data on the five variables of the DECAF score were collected, with outcomes measured in terms of survival, need for ventilation, and hospital stay duration. Results: A total of 200 consecutive patients were assessed. According to DECAF scoring, 102 patients (51%) fell into the low-risk category, with no recorded mortalities in this group. In contrast, the intermediate-risk group exhibited a mortality rate of 7.4%, while the high-risk group had a mortality rate of 38.6%, with these differences being statistically significant. Additionally, a higher dyspnea grade, as evaluated by the extended Modified Research Council (eMRCD) criteria, was significantly associated with both the DECAF score and patient outcomes. Conclusion: The findings suggest that the DECAF score at initial presentation is a robust tool for predicting outcomes in patients with AECOPD. DECAF scores can be easily applied in AECOPD patients so that death during hospitalization for AECOPD and need for mechanical ventilation can be minimized. Furthermore, dyspnea grading may serve as an indirect predictor of mortality.

Keywords: Chronic obstructive pulmonary disease; Dyspnea, Eosinopenia, Consolidation, Acidemia, and Atrial Fibrillation (DECAF); Mortality; AECOPD.