Rabih Tabet, Charbel Ardo, Paul Makhlouf and Jeff Hosry
Background and objectives: COPD is gaining importance in the field of public health because it is expected to become the third leading cause of death worldwide by 2020. Until today, there is no validated score for risk stratification of patients presenting with an exacerbation of COPD to the emergency department. The BAP-65 is a new score, published in 2011 in the «CHEST» journal, which was used to predict the need for mechanical ventilation and predict the risk of mortality in acute exacerbation of COPD. Thus, we decided to conduct this study and apply the BAP-65 score in Lebanon, in order to test its accuracy in correlating the clinical and biological status of the patient presenting with acute exacerbation of COPD with mortality risk and the possible use of MV. Methods: We analysed 980 admissions to two Lebanese hospitals (2005 through 2013) with a discharge diagnosis of acute exacerbation of COPD. The primary endpoints were hospital mortality and need for MV. We used the SPSS program - Version 17 in our analysis. Results:170 patients (17.3%) required mechanical ventilation and 59 patients (6%) passed away during hospitalization. Statistics showed that both end points increased with increasing BAP-65. 1.3% of patients with a score of 0 or 1 needed intubation, while 74% of patients with a score of 3 or 4 were intubated (P-value < 0.001). Moreover, <1% of patients with a score of 0 or 1 passed away, while 51% of patients with a score of 3 or 4 died (P-value < 0.001). Conclusions: The BAP-65 scoring system seems to be a useful and simple tool to classify the patients presenting with AECOPD, and it correlates with both need for mechanical ventilation and mortality. Most importantly, it showed consistent results when applied in different populations.
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