Abstract
Exacerbations of chronic obstructive pulmonary disease (COPDE) frequently require hospitalizations, may necessitate of invasive mechanical ventilation (IMV), and are associated with a remarkable in-hospital mortality. The BAP-65 score is a risk assessment model (RAM) based on simple variables, that has been proposed for the prediction of these adverse outcomes in patients with COPDE. If showed to be accurate, the BAP-65 RAM might be used to guide the patients management, in terms of destination and treatment. We conducted a retrospective, multicentre, chart-review study, on patients attending the ED for a COPDE during 2014. The aim of the study was the validation of the BAP-65 RAM for the prediction of in-hospital death or use of IMV (composite primary outcome). We assessed the discrimination and the prognostic performance of the BAP-65 RAM. We enrolled 2908 patients from 20 centres across Italy. The mean (standard deviation) age was 76 (11) years, and 38% of patients were female. The composite outcome occurred in 5.3% of patients. The AUROC of BAP-65 for the composite outcome was 0.64 (95%CI 0.59–0.68). The sensitivity of BAP-65 score ≥ 4 to predict in-hospital mortality was 44% (95% CI 34%–55%), the specificity was 84% (95% CI 82%–85%), the positive predictive value was 9% (95% CI 6%–12%), and the negative predictive value was 98% (95% CI 97%–98%). Conclusions: In patients attending Italian EDs with a COPDE, we found that the BAP-65 score did not have sufficient accuracy to stratify patients upon their risk of severe in-hospital outcomes.
| Original language | English |
|---|---|
| Pages (from-to) | 62-68 |
| Journal | European Journal of Internal Medicine |
| Volume | 61 |
| DOIs | |
| Publication status | Published - 2019 |
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Keywords
- Chronic obstructive
- Emergency service, Hospital
- Prognosis
- Pulmonary disease
- Risk
ASJC Scopus subject areas
- Internal Medicine
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Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Validation of the BAP-65 score for prediction of in-hospital death or use of mechanical ventilation in patients presenting to the emergency department with an acute exacerbation of COPD
T2 - a retrospective multi-center study from the Italian Society of Emergency Medicine (SIMEU)
AU - the SIMEU Study Group
AU - Germini, Federico
AU - Veronese, Giacomo
AU - Marcucci, Maura
AU - Coen, Daniele
AU - Ardemagni, Deborah
AU - Montano, Nicola
AU - Fabbri, Andrea
AU - Adinolfi, Luigi Elio
AU - Alvisi, Antonella
AU - Antonio, Pagano
AU - Azin, Giulia
AU - Balloni, Andrea
AU - Bandiera, Geminiano
AU - Barchetti, Marco
AU - Barillari, Alfredo
AU - Barozzi, Marco
AU - Belloni, Giulia
AU - Belotti, Eugenia
AU - Binetti, Nicola
AU - Bonora, Miriam
AU - Bruni, Rosamaria
AU - Cacco, Silvia
AU - Camisa, Daniele
AU - Carbone, Giorgio
AU - Carpinteri, Giuseppe
AU - Catino, Laura
AU - Cazzaniga, Massimo
AU - Cenni, Patrizia
AU - Chelli, Vittorio
AU - Cicero, Leonora
AU - Cottone, Carlo Domenico
AU - Cuccia, Filippa
AU - D'Angelo, Luciano
AU - Dalmonte, Francesca
AU - Daviddi, Fabio
AU - De Vita, Anna
AU - Famà, Fausto
AU - Fedele, Marta
AU - Fonti, Caterina
AU - Frigerio, Marta
AU - Gallingani, Alan
AU - Ghiglione, Valeria
AU - Gioffrè-Florio, Maria
AU - Giordano, Mauro
AU - Giostra, Fabrizio
AU - Galli, Maria Giulia
AU - Greggi, Maria Elena
AU - Groff, Paolo
AU - Guizzardi, Stefano
AU - Magni, Laura
PY - 2019
Y1 - 2019
N2 - Exacerbations of chronic obstructive pulmonary disease (COPDE) frequently require hospitalizations, may necessitate of invasive mechanical ventilation (IMV), and are associated with a remarkable in-hospital mortality. The BAP-65 score is a risk assessment model (RAM) based on simple variables, that has been proposed for the prediction of these adverse outcomes in patients with COPDE. If showed to be accurate, the BAP-65 RAM might be used to guide the patients management, in terms of destination and treatment. We conducted a retrospective, multicentre, chart-review study, on patients attending the ED for a COPDE during 2014. The aim of the study was the validation of the BAP-65 RAM for the prediction of in-hospital death or use of IMV (composite primary outcome). We assessed the discrimination and the prognostic performance of the BAP-65 RAM. We enrolled 2908 patients from 20 centres across Italy. The mean (standard deviation) age was 76 (11) years, and 38% of patients were female. The composite outcome occurred in 5.3% of patients. The AUROC of BAP-65 for the composite outcome was 0.64 (95%CI 0.59–0.68). The sensitivity of BAP-65 score ≥ 4 to predict in-hospital mortality was 44% (95% CI 34%–55%), the specificity was 84% (95% CI 82%–85%), the positive predictive value was 9% (95% CI 6%–12%), and the negative predictive value was 98% (95% CI 97%–98%). Conclusions: In patients attending Italian EDs with a COPDE, we found that the BAP-65 score did not have sufficient accuracy to stratify patients upon their risk of severe in-hospital outcomes.
AB - Exacerbations of chronic obstructive pulmonary disease (COPDE) frequently require hospitalizations, may necessitate of invasive mechanical ventilation (IMV), and are associated with a remarkable in-hospital mortality. The BAP-65 score is a risk assessment model (RAM) based on simple variables, that has been proposed for the prediction of these adverse outcomes in patients with COPDE. If showed to be accurate, the BAP-65 RAM might be used to guide the patients management, in terms of destination and treatment. We conducted a retrospective, multicentre, chart-review study, on patients attending the ED for a COPDE during 2014. The aim of the study was the validation of the BAP-65 RAM for the prediction of in-hospital death or use of IMV (composite primary outcome). We assessed the discrimination and the prognostic performance of the BAP-65 RAM. We enrolled 2908 patients from 20 centres across Italy. The mean (standard deviation) age was 76 (11) years, and 38% of patients were female. The composite outcome occurred in 5.3% of patients. The AUROC of BAP-65 for the composite outcome was 0.64 (95%CI 0.59–0.68). The sensitivity of BAP-65 score ≥ 4 to predict in-hospital mortality was 44% (95% CI 34%–55%), the specificity was 84% (95% CI 82%–85%), the positive predictive value was 9% (95% CI 6%–12%), and the negative predictive value was 98% (95% CI 97%–98%). Conclusions: In patients attending Italian EDs with a COPDE, we found that the BAP-65 score did not have sufficient accuracy to stratify patients upon their risk of severe in-hospital outcomes.
KW - Chronic obstructive
KW - Emergency service, Hospital
KW - Prognosis
KW - Pulmonary disease
KW - Risk
UR - http://www.scopus.com/inward/record.url?scp=85055752510&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85055752510&partnerID=8YFLogxK
U2 - 10.1016/j.ejim.2018.10.018
DO - 10.1016/j.ejim.2018.10.018
M3 - Article
AN - SCOPUS:85055752510
VL - 61
SP - 62
EP - 68
JO - European Journal of Internal Medicine
JF - European Journal of Internal Medicine
SN - 0953-6205
ER -