• Fatma Nur Karaarslan, ÖztürkZeynep SaralZSUniversity of Health Sciences Ankara Atatürk Sanatoryum Training and Research Hospital, Department of Emergency Medicine, Ankara, Turkey., IşıkGülşah ÇıkrıkçıGÇUniversity of Health Sciences Ankara Atatürk Sanatoryum Training and Research Hospital, Department of Emergency Medicine, Ankara, Turkey., and Yunsur Çevik.
• University of Health Sciences Ankara Atatürk Sanatoryum Training and Research Hospital, Department of Emergency Medicine, Ankara, Turkey. Electronic address: f.nurkaraarslan@gmail.com.
• Am J Emerg Med. 2023 Sep 1; 71: 545854-58.

PurposeIn this study, we aimed to examine the correlation between current prognostic scores and the integrated pulmonary index (IPI) in patients admitted to the emergency department (ED) with exacerbation of chronic obstructive pulmonary disease (COPD), and the diagnostic value of using the IPI in combination with other scores in determining patients who can be discharged safely.MethodsThis study was conducted as a multicenter and prospective observational study between August 2021 and June 2022. Patients diagnosed with COPD exacerbation (eCOPD) at the ED were included in the study and they were grouped according to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) classification. The CURB-65 (Confusion, Urea, Respiratory rate, Blood pressure, and age older than 65 years), BAP-65 (Blood urea nitrogen, Altered mental status, Pulse rate, and age older than 65 years), and DECAF (Dyspnea, Eosinopenia, Consolidation, Academia, and atrial Fibrillation) scores and IPI values of the patients were recorded. The correlation between the IPI and the other scores and its diagnostic value in detecting mild eCOPD were examined. The diagnostic value of CURB-IPI, a new score created by the combination of CURB-65 and IPI, in mild eCOPD was examined.ResultsThe study was carried out with 110 patients (49 female and 61 male), mean age of 67 (min/max: 40/97). The IPI and CURB-65 had better predictive value in detecting mild exacerbations than DECAF and BAP-65 scores [Area under curves (AUC) were 0.893, 0.795, 0.735, 0.541 respectively]. The CURB-IPI score, on the other hand, had the best predictive value for detecting mild exacerbations (AUC 0.909).ConclusionWe found that the IPI has good predictive value in the detection of mild COPD exacerbations, and its predictive value increases when used in combination with CURB-65. We think that the CURB-IPI score can be a guide when deciding whether patients with exacerbation of COPD can be discharged.Copyright © 2023 Elsevier Inc. All rights reserved.

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