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: a retrospective multi-center study from the Italian Society of Emergency Medicine (SIMEU)

the SIMEU Study Group

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1 Citation (Scopus)

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 languageEnglish
Pages (from-to)62-68
JournalEuropean Journal of Internal Medicine
Volume61
DOIs
Publication statusPublished - 2019

Fingerprint

Emergency Medicine
Artificial Respiration
Chronic Obstructive Pulmonary Disease
Hospital Emergency Service
Hospital Mortality
Validation Studies
Italy
Hospitalization

Keywords

  • Chronic obstructive
  • Emergency service, Hospital
  • Prognosis
  • Pulmonary disease
  • Risk

ASJC Scopus subject areas

  • Internal Medicine

Cite this

@article{426df6da8a2243bba5c3fc13e6b11066,
title = "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: a retrospective multi-center study from the Italian Society of Emergency Medicine (SIMEU)",
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.",
keywords = "Chronic obstructive, Emergency service, Hospital, Prognosis, Pulmonary disease, Risk",
author = "{the SIMEU Study Group} and Federico Germini and Giacomo Veronese and Maura Marcucci and Daniele Coen and Deborah Ardemagni and Nicola Montano and Andrea Fabbri and Adinolfi, {Luigi Elio} and Antonella Alvisi and Pagano Antonio and Giulia Azin and Andrea Balloni and Geminiano Bandiera and Marco Barchetti and Alfredo Barillari and Marco Barozzi and Giulia Belloni and Eugenia Belotti and Nicola Binetti and Miriam Bonora and Rosamaria Bruni and Silvia Cacco and Daniele Camisa and Giorgio Carbone and Giuseppe Carpinteri and Laura Catino and Massimo Cazzaniga and Patrizia Cenni and Vittorio Chelli and Leonora Cicero and Cottone, {Carlo Domenico} and Filippa Cuccia and Luciano D'Angelo and Francesca Dalmonte and Fabio Daviddi and {De Vita}, Anna and Fausto Fam{\`a} and Marta Fedele and Caterina Fonti and Marta Frigerio and Alan Gallingani and Valeria Ghiglione and Maria Gioffr{\`e}-Florio and Mauro Giordano and Fabrizio Giostra and Galli, {Maria Giulia} and Greggi, {Maria Elena} and Paolo Groff and Stefano Guizzardi and Laura Magni",
year = "2019",
doi = "10.1016/j.ejim.2018.10.018",
language = "English",
volume = "61",
pages = "62--68",
journal = "European Journal of Internal Medicine",
issn = "0953-6205",
publisher = "Elsevier B.V.",

}

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

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U2 - 10.1016/j.ejim.2018.10.018

DO - 10.1016/j.ejim.2018.10.018

M3 - Article

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VL - 61

SP - 62

EP - 68

JO - European Journal of Internal Medicine

JF - European Journal of Internal Medicine

SN - 0953-6205

ER -