Echevarria et al reported the PEARL score for a patient hospitalized with an acute exacerbation of chronic obstructive pulmonary disease(COPD). This can help to identify a patient at increased risk for a poor outcome. The authors are from multiple institutions in England.
Patient selection: hospitalization for an acute exacerbation of COPD
Outcome: 90-day readmission or death
Parameters:
(1) previous admissions (P)
(2) eMRCD score (E), extended MRC dyspnea score
(3) age in years (A)
(4) right-sided heart failure (R)
(5) left-sided heart failure (L)
Parameter
Finding
Points
previous admission
no
0
yes
3
eMRC dyspnea scale
< 4
0
4
1
5a
2
5b
3
age in years
< 80 years
0
>= 80 years
1
right heart failure
no
0
yes
1
left heart failure
no
0
yes
1
total score =
= SUM(points for all 5 parameters)
Interpretation:
• minimum score: 0
• maximum score: 9
• The higher the score the worse the prognosis.
Score
Risk Group
0 or 1
low
2 to 4
intermediate
5 to 9
high
Performance:
• The area under the ROC curve ranged from 0.68 to 0.73.
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