TY - JOUR
TI - Prediction of Hospitalization Stay in COPD Exacerbations: The AECOPD-F
Score
AU - Diamantea, Filia
AU - Kostikas, Konstantinos
AU - Bartziokas, Konstantinos
AU - and Karakontaki, Foteini
AU - Tsikrika, Stamatoula
AU - Pouriki, Sofia and
AU - Polychronopoulos, Vlassis
AU - Karagiannidis, Napoleon
AU - Haniotou,
AU - Aikaterini
AU - Papaioannou, Andriana I.
JO - Respiratory Care
PY - 2014
VL - 59
TODO - 11
SP - 1679-1686
PB - DAEDALUS ENTERPRISES INC
SN - 0020-1324
TODO - 10.4187/respcare.03171
TODO - COPD exacerbation; duration of hospital stay; predictors of outcomes;
dyspnea; comorbidities
TODO - BACKGROUND: Hospital admissions for COPD exacerbations account for 70%
of total costs of COPD treatment, and the duration of hospital stay is
directly related to this cost. The aim of this study was to investigate
possible associations of demographic, clinical, laboratory, and
functional parameters with stay of subjects admitted for COPD
exacerbations and to provide a score for the prediction of the need for
prolonged hospitalization. METHODS: We included 164 consecutive subjects
admitted to 2 respiratory medicine departments of 2 tertiary hospitals
for a COPD exacerbation, and we evaluated laboratory, clinical, and
functional parameters possibly related to the duration of hospital stay.
RESULTS: Seven parameters evaluated on subject admission (Antonisen type
of exacerbation, number of Exacerbations in the previous year, Charlson
index of comorbidities, Oxygenation, Partial pressure of P-acO2 in
arterial blood gases, Dyspnea according to the Borg dyspnea scale, and
history of chronic respiratory Failure) were able to predict stay and
were included in a simple score named AECOPD-F. The area under the curve
of the score for the prediction of prolonged hospital stay is 0.960, and
a cutoff point >= 3 predicts prolonged stay with a sensitivity of 84.5%
and a specificity of 92.5% (95% CI 0.917-0.984). The AECOPD-F score
was validated in a second group of 88 subjects admitted to the hospital
for a COPD exacerbation. In the validation group, subjects with a score
>= 3 required prolonged stay compared with those with a score < 3 (8.0
[6.0-10.0] vs 6.5 [4.0-9.0] d, respectively, P = .007). CONCLUSION:
The AECOPD-F score could accurately predict stay in hospitalized COPD
subjects. The implementation of this score in clinical practice could be
useful in the discharge planning of such subjects.
ER -