Asiimwe et al used CART analysis to predict outcome of an acute exacerbation of COPD based on laboratory values alone. This can help to identify a patient who may benefit from more aggressive management. The authors are from the University of Portsmouth, University College London, Portsmouth Hospitals NHS Trust and Queen Alexandra Hospital.
Patient selection: acute exacerbation of COPD requiring hospital admission
Parameters:
(1) serum albumin in g/L
(2) serum urea in mmol/L
(3) arterial pCO2 in kPa
Serum Albumin
Serum Urea
Arterial pCO2
Risk Group
<= 36.5
NA
NA
high (21-23%)
> 36.5
> 7.35
> 6.45
high (19-20%)
> 36.5
> 7.35
<= 6.45
low (7-10%)
> 36.5
<= 7.35
> 7.70
medium 17-18%)
> 36.5
<= 7.35
<= 7.70
low (3-4%)
where:
• The third rule could be viewed as medium risk and the fourth medium-to-high.
Performance:
• The area under the ROC curve was 0.73 in the derivation set and 0.70 in the validation set.
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