Performance of the DECAF score in predicting hospital mortality due to acute exacerbations of COPD.

Abstract

This study aimed to investigate the overall prognostic performance of the DECAF (dyspnoea, eosinopenia, consolidation, acidaemia, atrial fibrillation) score for in-hospital death in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) through a retrospective cohort study and an updated meta-analysis.Sensitivity, specificity, and predictive performance of DECAF were analysed, using receiver operating characteristic (ROC) curves and area under the curve (AUC) as criteria for accuracy. A literature search was performed in databases. The summary ROC (SROC) curve was used to assess the overall performance of the DECAF score.Twenty-three non-survivors and 292 survivors of AECOPD were included. At a cut-off value of 1.5, DECAF scores showed good sensitivity (78.3%), low specificity (55.1%), and AUC (0.719, 95% CI 0.614-0.824). Additionally, 22 studies (including our study) with 824 non-survivors and 8,957 survivors were included in this meta-analysis. The summary estimates were listed as follows: sensitivity 0.77 (95% CI 0.69-0.83); specificity 0.76 (95% CI 0.67-0.85); positive likelihood ratio 3.2 (95% CI 2.4-4.3); negative likelihood ratio 0.31 (95% CI 0.23-0.40); and diagnostic odds ratio 10.00 (95% CI 7-16). The AUC was 0.83 (95% CI 0.79-0.86).The DECAF score is a simple tool to predict mortality in hospitalised patients with AECOPD, and the results of this study should be further validated..