REPOCUR: thyrty-day risk model in adult patients with acute exacerbation of chronic obstructive pulmonary disease (COPD) discharged from the emergency department.

Abstract

Objective: Design a risk model to predict adverse outcome (AO) 30 days after discharge in adult patients treated for acute exacerbation (AE) of chronic obstructive pulmonary disease (COPD) in emergency departments (EDs).

Methods: PREURG was a prospective, observational, multi-purpose, multicenter cohort registry. Phone calls were made as part of a 30-day follow-up. The main variable was the presence of any AO (recurrence of COPD AE, ED revisit, hospitalization, institutionalization, or death) 30 days after being discharge from the ED.

Results: The study included a total of 931 patients with COPD AE (23.4% women and 76.6% men) discharged from the ED with follow-up data; 322 (34.6%) had an AO 30 days after being discharge from the ED. The REPOCUR model included the variable sex (OR for men of 1.50 [95%CI, 1.06-2.15]), severe COPD AE type (OR, 3.15 [95%CI, 2.02-5.04]), $ 2 COPD AE/year (OR, 1.64 [95%CI, 1.20-2.24]), and $ 4 ED visits/year (OR, 2.15 [95%CI, 1.52-3.04]). Each item is worth 1 point. The risk of experiencing an AO at 30 days with a score of 1 is 22.5%; 35.0% with a score of 2; 50.0% with a score of 3; and 65.1% with a score of 4. The area under the curve is 0.67 (95%CI, 0.64-0.71).

Conclusions: The REPOCUR model could be a useful prognostic tool to identify adult patients with COPD AE and a high risk of exhibing AO at 30 days after being discharged from the emergency department.