A STUDY ON THE PREDICTORS OF MORTALITY IN ACUTE EXACERBATIONS OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE USING DYSPNEA, EOSINOPENIA, CONSOLIDATION, ACIDEMIA AND ATRIAL FIBRILLATION SCORE (DECAF)IN A TERTIARY CENTRE.

Abstract

Introduction Chronic Obstructive Pulmonary Disease (COPD) has emerged as one of the primary causes of death globally with 90% of fatalities occurring in low- and middle-income countries. It is an enormous economic and social burden, with high morbidity and mortality. The DECAF score, a simple tool regularly employed by clinicians, is a predictive measure for in-hospital mortality and can be conveniently applied at the bedside for risk stratication during Acute Exacerbations of COPD (AECOPD). Material And Methods: A cross-sectional observational study was conducted involving 100 patients, aged between 40 and 82 years, with a mean age of 60, who presented to the OP and IP of the Department of Respiratory Medicine. Participants who met the inclusion criteria with a diagnosis of COPD were evaluated and their data was collected. Subsequently, a DECAF score was assigned to each patient. The study then observed in-hospital mortality and conducted a comparative analysis of the characteristics between survivors and non-survivors. Results: The study included 100 conrmed cases of COPD, ranging from 40 to 82 years old, with a mean age of 60.66 years. A male predominance was noted, as there were 77 males and 23 females in the study. An increase in the DECAF score corresponded to a higher utilization of ventilation. In the low-risk group (DECAF 0-1), only one patient required mechanical ventilation, while in the intermediate-risk group, 1 (6.25%) patient and in the high-risk group, 14 (87.5%) patients required mechanical ventilation. Conclusion: In patients admitted with acute exacerbation of COPD, the DECAF score is a benecial clinical tool for in-hospital prognosis. Assessing the DECAF score after admission due to AECOPD aids in decisions regarding early escalation of care, therapeutic interventions, evaluating the necessity for ICU admissions, determination of the need for assisted ventilation, decision-making in end-of-life care, and provides valuable information to clinicians for informing patients and relatives about life-threatening risks associated with exacerbation.