Clinical significance of the DECAF score in acute exacerbations of chronic obstructive pulmonary disease

Background

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Aim

The prognosis of chronic obstructive pulmonary disease (COPD) depends on the frequency and severity of exacerbations. The DECAF score (dyspnea, eosinopenia, consolidation, acidemia, and atrial fibrillation) is a cost-effective tool used to predict exacerbation outcomes. This study examines its relationship with six-month mortality following COPD exacerbations (ECOPD).

Methods

Patients (n=260) hospitalized at our center between December 15, 2021 and June 15, 2022 due to ECOPD were evaluated prospectively. Patients were classified into low-risk (DECAF score <2) and moderate-high-risk (DECAF score ≥2) groups. Patients who died within six months were compared with survivors in terms of their demographic and clinical characteristics. Independent risk factors associated with mortality were identified using logistic regression analysis.

Results

The study included 260 patients, 78.8% of whom were male, with a median age of 67 years. The moderate-high-risk group comprised 43.5% (n=113) of patients, and the low-risk group comprised 56.5% (n=147). Patients with a DECAF score ≥2 had a significantly higher six-month mortality rate (p=0.022). Regression analysis showed that mortality risk increased with the presence of congestive heart failure (CHF), higher blood urea nitrogen (BUN) levels, longer hospital stay, and lower hematocrit percentage and body mass index (BMI) values. However, the DECAF score did not emerge as an independent risk factor for six-month mortality following ECOPD.

Conclusions

Clinical parameters including BMI, length of hospital stay, hematocrit, BUN levels, and the presence of CHF can be used to determine six-month mortality risk in patients hospitalized due to ECOPD. However, the DECAF score was not found to be an independent predictor of six-month mortality.