Predictive score for mortality in patients with COPD exacerbations attending hospital emergency departments

Table 3 Predictors of short-term mortality and 1 month mortality in the derivation sample

Outcome prediction model/parameter	Estimate	OR	95% CI of the AUC	Pvalue	Score
Short-term mortality^a
Age, years
75 to 85 versus <75	0.2417	1.273	0.540 to 3.003	0.5808	0
>85 versus <75	1.3062	3.692	1.134 to 12.022	0.0301	3
Previous use of LTHOT or NIMV at home	1.1557	3.176	1.278 to 7.893	0.0128	3
Altered consciousness	1.1852	3.271	1.031 to 10.376	0.0442	3
Use of inspiratory accessory muscle or paradoxical breathing upon ED arrival	1.4740	4.367	1.912 to 9.972	0.0005	4
Baseline dyspnea (MRC scale)
Grade 5 versus grades 1 to 4	2.0456	7.734	2.923 to 20.463	<0.0001	5
Missing versus grades 1 to 4	2.5581	12.912	4.654 to 35.821	<0.0001	5
^bDerivation sample: AUC_model = 0.85 (0.77 to 0.93); AUC_score = 0.85 (0.77 to 0.93) AUC_{score _ cat} = 0.84 (0.76 to 0.91)
^bValidation sample: AUC_model = 0.88 (0.82 to 0.94); AUC_score = 0.84 (0.77 to 0.92) AUC_{score _ cat} = 0.85(0.78 to 0.92)
1 month mortality (validation sample)
Age, years
75 to 85 versus <75	0.8199	2.270	1.092 to 4.719	0.0281
>85 versus <75	1.9253	6.857	2.701 to 17.411	<0.0001
Previous use of LTHOT or NIMV at home	1.3737	3.950	1.956 to 7.976	0.0001
Altered consciousness	0.9513	2.589	0.887 to 7.557	0.0817
Use of inspiratory accessory muscle or paradoxical breathing upon ED arrival	1.2508	3.493	1.850 to 6.596	0.0001
Baseline dyspnea (MRC scale)
Grade 5 versus grades 1 to 4	1.1743	3.236	1.581 to 6.625	0.0013
Missing versus grades 1 to 4	1.3324	3.790	1.643 to 8.742	0.0018
^bValidation sample: AUC_model = 0.85 (0.81 to 0.90); AUC_score = 0.83 (0.78 to 0.88); AUC_{score _ cat} = 0.83 (0.78 to 0.88)

Abbreviations: AUC area under the receiver operating characteristic curve, LTHOT long-term home oxygen therapy, MRC Medical Research Council, NIMV non-invasive mechanical ventilation.
^aShort-term mortality: mortality during hospital admission or, if discharged from the ED, in 1 week.
^bAUCs are the results for the whole model, the continuous score, and the categorical score, respectively.

ISSN: 1741-7015