A Frailty Assessment Tool to Predict In-Hospital Mortality in Patients with Acute Exacerbations of Chronic Obstructive Pulmonary Disease

Int J Chron Obstruct Pulmon Dis. 2021 Apr 20:16:1093-1100. doi: 10.2147/COPD.S300980. eCollection 2021.

Abstract

Background: The exacerbation of chronic obstructive pulmonary disease (AECOPD) is a chronic, frequent, and life-threatening lung disease. In 2014, a frailty index (FI) based on deficits in commonly used laboratory tests (FI-Lab) was suggested to identify older adults at increased risk of death.

Objective: We aim to study the prognostic value of the FI-Lab in older Chinese patients who were admitted because of AECOPD.

Methods: We screened 1932 older patients hospitalized with AECOPD from September 2016 to June 2019 at Zhenjiang First People's Hospital, China. A multivariate logistic regression analysis was used to identify prognostic factors for in-hospital mortality.

Results: A total of 77 survivors and 77 non-survivors were finally included in the study. Both the mean DECAF (including dyspnea, eosinopenia, consolidation, acidemia, and atrial fibrillation) score and the mean FI-Lab value of non-survivors were statistically higher than those of survivors (4.45 ± 0.80 versus 3.03 ± 0.90, P=0.000; 0.51 ± 0.13 versus 0.29 ± 0.10, P=0.000, respectively). Logistic regression analysis suggested that DECAF Rank and FI-Lab Rank were strongly related factors of death in AECOPD patients. The areas under the receiver-operating characteristic (ROC) curves were 0.906 for FI-Lab and 0.870 for DECAF (P=0.2991).

Conclusion: FI-Lab is a simple, efficient, and objective tool to stratify the risk of in-hospital mortality of AECOPD.

Keywords: AECOPD; DECAF; FI-Lab; frailty index; prognosis.

MeSH terms

  • Aged
  • China / epidemiology
  • Disease Progression
  • Frailty* / diagnosis
  • Hospital Mortality
  • Humans
  • Prognosis
  • Pulmonary Disease, Chronic Obstructive* / diagnosis
  • Severity of Illness Index