Abstract

Background: Chronic obstructive pulmonary disease (COPD) is a prominent cause of illness and mortality on
a global scale. In 2019, it was predicted to rank as the sixth largest cause of mortality. COPD is one of the
most prevalent non-communicable illnesses in the field of pulmonology. The DECAF score
(Dyspnea, Eosinopenia, Consolidation, Acidemia, and Atrial Fibrillation) is a risk stratification tool for
patients with AECOPD that can be used at the bedside to guide treatment, such as hospital at home for
low-risk patients. The purpose of this study is to predict the in-hospital mortality in acute exacerbation of
COPD patients with modified DECAF scores. Modified DECAF score includes Dyspnea,
Eosinopenia, Consolidation, Acidemia and Frequency of Hospitalization.
Material and Methods: A total of 50 patients attending Emergency Medicine Department with Acute
Exacerbation of COPD were recruited to this hospital based observational study. This study was conducted
at the Department of Emergency medicine & Pulmonary medicine, at APOLLO GLENEAGLES HOSPITALS, Kolkata.
Results: COPD was more prevalent in the age groups of 41-50 years (28%) and 61-70 years (28%) followed
by those having age between 51-60 years (22%). Majority of the COPD patients were males (88%) compared
to (12%) females. Majority of the COPD patients were males (88%) compared to (12%) females.
Most common co-morbid condition associated with COPD washypertension (16%) followed by
IHD (8%), pulmonary hypertension (6%) and diabetes mellitus (4%). Out of 50 patients with COPD,
11 (22%) had previous history of AECOPD, 38 (76%) were regular user of inhaler, 33 (66%) had
history of influenza vaccination, 16 (32%) had Pneumococcal Vaccination and 2 (4%) patients had
COVID-19 pneumonia. Out of 50 patients, 24 (48%) had Dyspnea (eMRCD) score
of 5a whereas 26 (52%) had Dyspnea (eMRCD) score of 5b as well as 7 (14%) had Eosinopenia
 (<50 cells/mm3) and 20 (40%) had Consolidation.
Conclusion: We conclude that the Modified DECAF score is both sensitive and specific in predicting
in-hospital mortality in AECOPD patients. Modified DECAF is a simple tool that predicts mortality
that incorporates routinely available indices. It effectively stratifies COPD patients admitted with
acute exacerbations into mortality risk categories.