1. 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)
- Author
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Antonella Alvisi, Eloisa Lubini, Maura Marcucci, Chiara Lagasio, Maria Elena Greggi, Miriam Bonora, Margherita Maragno, Filippa Cuccia, Federica Molinaro, Silvia Cacco, Aferdita Tafa, Massimo Zacchino, Geminiano Bandiera, Maria Giulia Galli, Paola Noto, Luciano D'Angelo, Francesco Moscariello, Alfredo Barillari, Nicola Montano, Laura Catino, Giuseppe Carpinteri, Fiorella Paladino, Bruna Zaccaro, Laura Magni, Monia Menabue, Deborah Ardemagni, Roberta Petrino, Federico Germini, Daniele Camisa, Mauro Giordano, Giacomo Veronese, Maria Gioffrè-Florio, Giuseppina Petrelli, Daniele Coen, Cinzia Zaccagni, Giulia Maria Azin, Sergio Tartaglia, Fabio Daviddi, Pagano Antonio, Andrea Balloni, Carlo Domenico Cottone, Nicola Binetti, Rosamaria Bruni, Giuseppe Lazzara, Stefano Guizzardi, Giulia Belloni, Alan Gallingani, Eleonora Meoni, Marco Barozzi, Riccardo Nevola, Giuseppe Mangano, Alessandra Vitelli, Francesca Dalmonte, Leonora Cicero, Massimo Cazzaniga, Andrea Fabbri, Paolo Groff, Martina Treleani, Luigi Elio Adinolfi, Marta Frigerio, Caterina Fonti, Chiara Taurino, Carmine Sinno, Vittorio Chelli, Eugenia Belotti, Anna De Vita, Alice Morelli, Roberta Pancani, Sandro Mancarella, Fabrizio Giostra, Liliana Villari, Giorgio Carbone, Valeria Ghiglione, Marco Barchetti, Patrizia Cenni, Marta Fedele, Fausto Famà, Germiniau, Federico, Aw, Av, ⁎, Veroneseax, Giacomo, Marcucciau, Maura, Coenax, Daniele, Ardemagniay, Deborah, Az, Montanoaw, Nicola, Fabbriba, Andrea, SIMEU Study Group (Luigi Elio Adinolfia, The, Alvisib, Antonella, Antonioc, Pagano, Azind, Giulia, Ballonie, Andrea, Bandieraf, Geminiano, Barchettig, Marco, Barillarih, Alfredo, Barozzii, Marco, Bellonij, Giulia, Belottik, Eugenia, Binettil, Nicola, Bonoram, Miriam, Brunin, Rosamaria, Caccoo, Silvia, Camisap, Daniele, Carboneq, Giorgio, Carpinterir, Giuseppe, Catinos, Laura, Cazzanigat, Massimo, Cenniu, Patrizia, Chelliv, Vittorio, Cicerow, Leonora, Domenico Cottonex, Carlo, Cucciay, Filippa, D'Angelot, Luciano, Dalmontez, Francesca, Daviddiaa, Fabio, De Vitaab, Anna, Famàac, Fausto, Fedelead, Marta, Fontiq, Caterina, Frigerioae, Marta, Gallinganiaf, Alan, Ghiglioneag, Valeria, Gioffrè-Florioac, Maria, Giordano, Mauro, Giostraae, Fabrizio, Giulia Galliah, Maria, Elena Greggix, Maria, Groffai, Paolo, Guizzardiaj, Stefano, Lagasioag, Chiara, Lazzaraaj, Giuseppe, Lubiniak, Eloisa, Magnial, Laura, Mancarellaam, Sandro, Manganor, Giuseppe, Maragnoy, Margherita, Menabuean, Monia, Meoniaa, Eleonora, Molinaroq, Federica, Morelliao, Alice, Moscarielloap, Francesco, Nevolaab, Riccardo, Notor, Paola, Paladinoaq, Fiorella, Pancaniar, Roberta, Petrelliai, Giuseppina, Petrinoas, Roberta, Sinnoy, Carmine, Tafav, Aferdita, Tartagliaas, Sergio, Taurinoar, Chiara, Treleaniap, Martina, Villariar, Liliana, Vitelliaq, Alessandra, Zaccagniam, Cinzia, Zaccaroy, Bruna, and Zacchinoa, Massimo
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Male ,Risk ,medicine.medical_specialty ,Exacerbation ,medicine.medical_treatment ,Pulmonary disease ,030204 cardiovascular system & hematology ,Risk Assessment ,Chronic obstructive ,Pulmonary Disease, Chronic Obstructive ,03 medical and health sciences ,Hospital ,0302 clinical medicine ,Chronic obstructive, Emergency service, Hospital, Prognosis, Pulmonary disease, Risk, Internal Medicine ,Predictive Value of Tests ,medicine ,Internal Medicine ,Humans ,In patient ,Hospital Mortality ,030212 general & internal medicine ,Aged ,Retrospective Studies ,Aged, 80 and over ,Mechanical ventilation ,COPD ,business.industry ,Emergency department ,medicine.disease ,Prognosis ,Respiration, Artificial ,Logistic Models ,Italy ,ROC Curve ,Multi center study ,Multivariate Analysis ,Emergency medicine ,Female ,Emergency Service, Hospital ,business ,Risk assessment ,Emergency service - 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. © 2018 European Federation of Internal Medicine
- Published
- 2018