Perbandingan antara Skor DECAF dengan Skor BAP-65 terhadap Kematian Tiga Puluh Hari pada Pasien PPOK Eksaserbasi Akut di RSUP H. Adam Malik Medan

Abstract

Background --- The assessment of level severity in patient with acute exacerbation COPD (AECOPD) is very important to determine the risk of inhospital mortality, requirement ICU setting and next management of disease. Several strongest predictors of mortality such as eosinophil, blood gas analysis, renal function test and other measurement were combined, to assess of level severity. The application of DECAF score and BAP-65 score is known to be used in prediction of mortality, to help clinician to decide treatment and to make prognosis. DECAF score performed significantly better for prediction of mortality than BAP-65 score. Objective --- To determine comparison between DECAF score and BAP-65 score to predict 30 days-mortality in AECOPD patients Materials and Methods --- This was an cohort study. We had examined AECOPD subject with DECAF score (Dyspnoea, Eosinopenia, Consolidation, Acidaemia, Atrial Fibrillation) and BAP-65 score (Elevated BUN, Altered mental status, Pulse l 09 beats/min, Age > 65 years), other laboratory assessment, spirometry, chest X-ray and ECG at the early admission at emergency room (ER). We had calculate sensitivity and specificity of DECAF score and BAP-65 score and compare the strongest predictor to predict 30-days mortality to determined prognostic utility of this score. Result-- 40 subject were recruited, mean(± SD) age was 61,07 ± 12,42 years, 75% subjects were male, and 9 subject died during the study. This study

performed significantly result of DECAF score p value 0,003 {p < 0,05) and BAP- 65 score p value 0,0026 (p < 0,05) to predict 30-days mortality in AECOPD,

using chi square test. Sensitivity and specificity DECAF score were I 00% and 16%, sensitivity and specitifity BAP-65 score were I 00% and 39%. Conclusion --- DECAF score and BAP-65 score have correlation with 30-days mortality in AECOPD patients. High sensitivity and low specificity made this score have not been used to predict 30-days mortality and prognostic tools.