An observational study on the role of decaf and HACOR score in predicting the outcome of NIV and mortality in patients with chronic obstructive pulmonary disease

Abstract

AN OBSERVATIONAL STUDY ON THE ROLE OF DECAF AND HACOR SCORE IN PREDICTING THE OUTCOME OF NIV AND MORTALITY IN PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE

                                        ABSTRACT

Background

Chronic Obstructive Pulmonary Disease (COPD)is now one of the top three causes of death world wide and 90 % of death is in low income countries. Globally, the COPD burden is projected to increase in coming decades because of continued exposure to COPD risk factors and ageing of population.

This study aims at using DECAF and HACOR scores in predicting NIV and mortality outcome in patients with chronic obstructive pulmonary disease  as these scoring systems are simple and effective  to improve their clinical outcome.

AIM OF THE STUDY

1.To evaluate the outcome of NIV and mortality in patients with chronic obstructive pulmonary disease using DECAF and HACOR score.

2.To assess the severity of chronic obstructive pulmonary disease patients using DECAF and HACOR score

RESULTS

HACOR exhibits excellent predictive power for anticipating NIV failure in COPD patients. Our study revealed a low NIV failure rate of only 16.6%, suggesting that NIV can be effectively utilized in the majority of COPD patients experiencing acute-on-chronic respiratory failure with respiratory acidosis.

NIV failure is better predicted with HACOR score than DECAF score, HACOR score appears to have a higher discriminative ability, especially at the 24-hour mark, compared to the DECAF score. Sensitivity   and specificity of HACOR is 77.8% and 79% at one hour . At 24hr sensitivity is 88.9% and specificity is 87.7%.

In our study DECAF score predicted length of hospital stay better than HACOR score with p value of 0.003. Thus combining both scores in assessing NIV failure, length of hospital stay and mortality would be better.

Conclusion

Combined HACOR and DECAF score have high sensitivity and specificity for predicting NIV failure, hospital mortality and length of hospital stay in a patients with acute exacerbation of COPD. DECAF and HACOR scoring system are simple tool which helps to detect patient with high risk thus better care can be given and helps to improve their clinical outcome.

Key words-Chronic obstructive pulmonary disease, HACOR ,DECAF score, NIV failure