Validation of the BAP-65 score for prediction of in-hospital death or use of mechanical ventilation in patients presenting to the emergency department with an acute exacerbation of COPD: a retrospective multi-center study from the Italian Society of Emergency Medicine (SIMEU)

Autor: Antonella Alvisi, Eloisa Lubini, Maura Marcucci, Chiara Lagasio, Maria Elena Greggi, Miriam Bonora, Margherita Maragno, Filippa Cuccia, Federica Molinaro, Silvia Cacco, Aferdita Tafa, Massimo Zacchino, Geminiano Bandiera, Maria Giulia Galli, Paola Noto, Luciano D'Angelo, Francesco Moscariello, Alfredo Barillari, Nicola Montano, Laura Catino, Giuseppe Carpinteri, Fiorella Paladino, Bruna Zaccaro, Laura Magni, Monia Menabue, Deborah Ardemagni, Roberta Petrino, Federico Germini, Daniele Camisa, Mauro Giordano, Giacomo Veronese, Maria Gioffrè-Florio, Giuseppina Petrelli, Daniele Coen, Cinzia Zaccagni, Giulia Maria Azin, Sergio Tartaglia, Fabio Daviddi, Pagano Antonio, Andrea Balloni, Carlo Domenico Cottone, Nicola Binetti, Rosamaria Bruni, Giuseppe Lazzara, Stefano Guizzardi, Giulia Belloni, Alan Gallingani, Eleonora Meoni, Marco Barozzi, Riccardo Nevola, Giuseppe Mangano, Alessandra Vitelli, Francesca Dalmonte, Leonora Cicero, Massimo Cazzaniga, Andrea Fabbri, Paolo Groff, Martina Treleani, Luigi Elio Adinolfi, Marta Frigerio, Caterina Fonti, Chiara Taurino, Carmine Sinno, Vittorio Chelli, Eugenia Belotti, Anna De Vita, Alice Morelli, Roberta Pancani, Sandro Mancarella, Fabrizio Giostra, Liliana Villari, Giorgio Carbone, Valeria Ghiglione, Marco Barchetti, Patrizia Cenni, Marta Fedele, Fausto Famà
Přispěvatelé: Germiniau, Federico, Aw, Av, ⁎, Veroneseax, Giacomo, Marcucciau, Maura, Coenax, Daniele, Ardemagniay, Deborah, Az, Montanoaw, Nicola, Fabbriba, Andrea, SIMEU Study Group (Luigi Elio Adinolfia, The, Alvisib, Antonella, Antonioc, Pagano, Azind, Giulia, Ballonie, Andrea, Bandieraf, Geminiano, Barchettig, Marco, Barillarih, Alfredo, Barozzii, Marco, Bellonij, Giulia, Belottik, Eugenia, Binettil, Nicola, Bonoram, Miriam, Brunin, Rosamaria, Caccoo, Silvia, Camisap, Daniele, Carboneq, Giorgio, Carpinterir, Giuseppe, Catinos, Laura, Cazzanigat, Massimo, Cenniu, Patrizia, Chelliv, Vittorio, Cicerow, Leonora, Domenico Cottonex, Carlo, Cucciay, Filippa, D'Angelot, Luciano, Dalmontez, Francesca, Daviddiaa, Fabio, De Vitaab, Anna, Famàac, Fausto, Fedelead, Marta, Fontiq, Caterina, Frigerioae, Marta, Gallinganiaf, Alan, Ghiglioneag, Valeria, Gioffrè-Florioac, Maria, Giordano, Mauro, Giostraae, Fabrizio, Giulia Galliah, Maria, Elena Greggix, Maria, Groffai, Paolo, Guizzardiaj, Stefano, Lagasioag, Chiara, Lazzaraaj, Giuseppe, Lubiniak, Eloisa, Magnial, Laura, Mancarellaam, Sandro, Manganor, Giuseppe, Maragnoy, Margherita, Menabuean, Monia, Meoniaa, Eleonora, Molinaroq, Federica, Morelliao, Alice, Moscarielloap, Francesco, Nevolaab, Riccardo, Notor, Paola, Paladinoaq, Fiorella, Pancaniar, Roberta, Petrelliai, Giuseppina, Petrinoas, Roberta, Sinnoy, Carmine, Tafav, Aferdita, Tartagliaas, Sergio, Taurinoar, Chiara, Treleaniap, Martina, Villariar, Liliana, Vitelliaq, Alessandra, Zaccagniam, Cinzia, Zaccaroy, Bruna, Zacchinoa, Massimo
Jazyk: angličtina
Rok vydání: 2018
Předmět:
Male
Risk
medicine.medical_specialty
Exacerbation
medicine.medical_treatment
Pulmonary disease
030204 cardiovascular system & hematology
Risk Assessment
Chronic obstructive
Pulmonary Disease
Chronic Obstructive

03 medical and health sciences
Hospital
0302 clinical medicine
Chronic obstructive
Emergency service
Hospital
Prognosis
Pulmonary disease
Risk
Internal Medicine

Predictive Value of Tests
medicine
Internal Medicine
Humans
In patient
Hospital Mortality
030212 general & internal medicine
Aged
Retrospective Studies
Aged
80 and over

Mechanical ventilation
COPD
business.industry
Emergency department
medicine.disease
Prognosis
Respiration
Artificial

Logistic Models
Italy
ROC Curve
Multi center study
Multivariate Analysis
Emergency medicine
Female
Emergency Service
Hospital

business
Risk assessment
Emergency service
Popis: Exacerbations of chronic obstructive pulmonary disease (COPDE) frequently require hospitalizations, may necessitate of invasive mechanical ventilation (IMV), and are associated with a remarkable in-hospital mortality. The BAP-65 score is a risk assessment model (RAM) based on simple variables, that has been proposed for the prediction of these adverse outcomes in patients with COPDE. If showed to be accurate, the BAP-65 RAM might be used to guide the patients management, in terms of destination and treatment. We conducted a retrospective, multicentre, chart-review study, on patients attending the ED for a COPDE during 2014. The aim of the study was the validation of the BAP-65 RAM for the prediction of in-hospital death or use of IMV (composite primary outcome). We assessed the discrimination and the prognostic performance of the BAP-65 RAM. We enrolled 2908 patients from 20 centres across Italy. The mean (standard deviation) age was 76 (11) years, and 38% of patients were female. The composite outcome occurred in 5.3% of patients. The AUROC of BAP-65 for the composite outcome was 0.64 (95%CI 0.59–0.68). The sensitivity of BAP-65 score ≥ 4 to predict in-hospital mortality was 44% (95% CI 34%–55%), the specificity was 84% (95% CI 82%–85%), the positive predictive value was 9% (95% CI 6%–12%), and the negative predictive value was 98% (95% CI 97%–98%). Conclusions: In patients attending Italian EDs with a COPDE, we found that the BAP-65 score did not have sufficient accuracy to stratify patients upon their risk of severe in-hospital outcomes. © 2018 European Federation of Internal Medicine
Databáze: OpenAIRE