Steer et al developed a model for predicting in-hospital mortality for a patient hospitalized for an exacerbation of chronic obstructive pulmonary disease (COPD). The authors are from North Tyneside General Hospital and Newcastle University in England.
The 5 parameters with the highest beta-coefficient were used to develop the DECAF score.
Patient selection: adult admitted with an acute exacerbation of COPD
Parameters:
(1) dyspnea by the extended MRCD scale
(2) eosinopenia
(3) consolidation with a new infiltrate on chest X-ray
(4) acidosis based on arterial pH
(5) atrial fibrillation
(6) ineffective cough
(7) serum albumin in g/dL
(8) cerebrovascular disease
(9) age in years
(10) body mass index (BMI)
Parameter
Finding
beta coefficient
dyspnea
not homebound
0
homebound, independent in ADL (eMRCD 5a)
1.63
homebound, dependent in ADL (eMRCD 5b)
1.99
eosinophil count
>= 50 per µL
0
< 50 per µL
1.02
consolidation
absent
0
present
1.09
arterial pH
>= 7.3
0
< 7.3
0.99
atrial fibrillation
absent
0
present
0.98
ineffective cough
no
0
yes
0.94
serum albumin
>= 3.6 g/dL
0
< 3.6 g/dL
0.84
cerebrovascular disease
absent
0
present
0.70
age
< 80 years
0
>= 80 years
0.70
BMI
>= 18.5 kg per sq meter
0
< 18.5 kg per sq meter
0.60
X =
= SUM(beta coefficients for the 10 parameters) - 4.30
probability of in-hospital mortality =
= 1 / (1 + EXP((-1) * X))
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