Deepika Shree Balaram1, Narendra Kumar Narahari2, Bhaskar Kakarla3, Rajasekhar Varma Gande4, Paramjyothi Kruparao Gongati5
BACKGROUND
Acute exacerbation of chronic obstructive pulmonary disease (AECOPD) carries a
significant morbidity and mortality with a need for frequent hospitalizations and
mechanical ventilation. Thus, a model was searched that required simple
information that was consistently available in emergency department, upon the
presentation of the patient which allowed risk stratification and to identify patients
who might potentially benefit from early intervention.
METHODS
This was a prospective observational study conducted over a period of 6 months,
from May 2018 to December 2018 with a study sample of 136 patients. The
primary objective was aimed to validate the BAP-65 score system in predicting the
need for ventilatory support and mortality in patients who presented with acute
exacerbation of COPD.
RESULTS
Mean age of the study population was 64.13 ± 9.7 and 29 (21.32 %) were females
with obvious male predominance. It was observed that as the BAP-65 score
increases, the mortality increases. Mortality among the score groups 0, 1 and 2
was one, zero, one respectively. The mortality is about 37.5 % in the score group
3 and it increased to 90.9 % in the score group 4. The patients who needed
mechanical ventilation were about 4 % in the score group 2 and it increased to
100 % in the score group 4. BAP-65 scoring system had a sensitivity of 88.89 %
and specificity of 90.68 % in predicting the in-hospital mortality, and a sensitivity
of 84 % and specificity of 94.59 % in predicting the need for mechanical ventilation
during hospital stay.
CONCLUSIONS
The BAP-65 scoring system seems to be a promising tool which is simple and
accurate. The score correlated well with both the mortality and also the need for
mechanical ventilation, thus helping in decision making at triage level and also in
prognostication of the disease.
