CAB score predicts short-term mortality at hospital admission for acute exacerbations of COPD

Abstract

Background: Acute exacerbations of COPD (AECOPD) are associated with increased short-term mortality. Predictive models for adverse outcomes are not sufficiently defined to be useful in clinical practice to enable clinicians to deal with management decisions at admission. Methods: A retrospective cohort study, including all patients admitted to our hospital with AECOPD between June 2011 and December 2012 was performed. The aim of this study was to assess the mortality rate and to identify potential predictors for 90-days mortality. Conventional descriptive statistics were used to select potential predictive factors. A classification and regression tree (CART) model was used to create a scoring system based on the variables with the highest discriminatory power. Results: 364 Hospitalized patients were enrolled. Mean (SD) age was 70.5 (10.20) years, 54.4% were male and mean FEV1 45.2% (17.7) of predicted. The in–hospital and 90-day mortality were 8.5% and 16.2%, respectively. Independent risk factors for 90-day mortality were: age (odds ratio (OR)=1.093; 95% confidence interval (CI)=1.180-1.517), pC02 (OR=1.31; 95% CI=1.18-1.47), supported living (OR=3.2; 95% CI=1.69-6.46), BMI 9.1 kPa, with 49% mortality), medium risk (Age>80 or BMI Conclusion: The CART method suggested an easy to apply model for predicting adverse outcomes, the CAB score (pCO2, Age, BMI). Replication in in a larger could lead to improved clinical management in the future.