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BAP-65 Class in Chronic Obstructive Pulmonary Disease (COPD)

Purpose: To evaluate a patient with COPD who is experiencing an exacerbation using the BAP-65 model of Tabak et al.

Description

Tabak et al described risk classes associated with the acronym BAP-65 (BUN, altered mental status, pulse, age relative to 65 years) for patients experiencing an exacerbation of COPD. This can help to triage patients at hospital admission based on expected need for mechanical ventilation and mortality. The authors are from Cardinal Health in Marlborough, Massachusetts, Harvard Medical School in Boston, and Washington Hospital Center in Washington, D.C.


Parameters:

(1) BUN in mg/dL (B)

(2) altered mental status (A)

(3) pulse in beats per minute (P)

(4) age in years (65)

 

Parameter

Finding

Points

BUN in mg/dL

<= 25 mg/dL

0

 

> 25 mg/dL

1

altered mental status

GCS >= 14 AND NOT(disoriented, stuporous, comatose)

0

 

GCS < 14 OR disoriented OR stuporous OR comatoase

1

pulse in beats per minute

<= 109

0

 

> 109

1

 

where:

• GCS = Glasgow Coma Score

 

BAP score =

= SUM(points for the 3 parameters)

 

BAP Score

Age in Years

Class

0

<= 65 years

1

0

> 65 years

2

1

NA

3

2

NA

4

3

NA

5

 

 

Class

Mechanical Ventilation within 48 Hours of Hospital Admission

Mortality Rate

1

0.3%

0.3%

2

0.2%

1%

3

1%

2%

4

5%

6%

5

10-12%

14%

 


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Specialty

Objective

ICD-10