A simple clinical risk score (ABCDMP) for predicting mortality in patients with AECOPD and cardiovascular diseases

Jiarui Zhang; Qun Yi; Chen Zhou; Yuanming Luo; Hailong Wei; Huiqing Ge; Huiguo Liu; Jianchu Zhang; Xianhua Li; Xiufang Xie; Pinhua Pan; Mengqiu Yi; Lina Cheng; Hui Zhou; Liang Liu; Adila Aili; Yu Liu; Lige Peng; Jiaqi Pu; Haixia Zhou

doi:10.1186/s12931-024-02704-6

A simple clinical risk score (ABCDMP) for predicting mortality in patients with AECOPD and cardiovascular diseases

Respir Res. 2024 Feb 10;25(1):89. doi: 10.1186/s12931-024-02704-6.

Authors

Jiarui Zhang^#¹, Qun Yi^#^{1

2}, Chen Zhou³, Yuanming Luo⁴, Hailong Wei⁵, Huiqing Ge⁶, Huiguo Liu⁷, Jianchu Zhang⁸, Xianhua Li⁹, Xiufang Xie⁹, Pinhua Pan¹⁰, Mengqiu Yi¹¹, Lina Cheng¹¹, Hui Zhou¹², Liang Liu¹², Adila Aili¹, Yu Liu¹, Lige Peng¹, Jiaqi Pu¹, Haixia Zhou¹³

Affiliations

¹ Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Guo-xue-xiang 37#, Wuhou District, Chengdu, 610041, Sichuan Province, China.
² Sichuan Cancer Hospital, University of Electronic Science and Technology of China, Chengdu, Sichuan Province, China.
³ West China School of Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China.
⁴ State Key Laboratory of Respiratory Disease, Guangzhou Medical University, Guangzhou, Guangdong Province, China.
⁵ Department of Respiratory and Critical Care Medicine, People's Hospital of Leshan, Leshan, Sichuan Province, China.
⁶ Department of Respiratory and Critical Care Medicine, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China.
⁷ Department of Respiratory and Critical Care Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China.
⁸ Department of Respiratory and Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China.
⁹ Department of Respiratory and Critical Care Medicine, the First People's Hospital of Neijiang City, Neijiang, Sichuan Province, China.
¹⁰ Department of Respiratory and Critical Care Medicine, Xiangya Hospital, Central South University, Changsha, Hunan Province, China.
¹¹ Department of Emergency, First People's Hospital of Jiujiang, Jiu jiang, Jiangxi Province, China.
¹² Department of Respiratory and Critical Care Medicine, The Affiliated Hospital of Chengdu University, Chengdu, Sichuan Province, China.
¹³ Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Guo-xue-xiang 37#, Wuhou District, Chengdu, 610041, Sichuan Province, China. zhouhaixia@wchscu.cn.

^# Contributed equally.

Abstract

Background: The morbidity and mortality among hospital inpatients with AECOPD and CVDs remains unacceptably high. Currently, no risk score for predicting mortality has been specifically developed in patients with AECOPD and CVDs. We therefore aimed to derive and validate a simple clinical risk score to assess individuals' risk of poor prognosis.

Study design and methods: We evaluated inpatients with AECOPD and CVDs in a prospective, noninterventional, multicenter cohort study. We used multivariable logistic regression analysis to identify the independent prognostic risk factors and created a risk score model according to patients' data from a derivation cohort. Discrimination was evaluated by the area under the receiver-operating characteristic curve (AUC), and calibration was assessed by the Hosmer-Lemeshow goodness-of-fit test. The model was validated and compared with the BAP-65, CURB-65, DECAF and NIVO models in a validation cohort.

Results: We derived a combined risk score, the ABCDMP score, that included the following variables: age > 75 years, BUN > 7 mmol/L, consolidation, diastolic blood pressure ≤ 60 mmHg, mental status altered, and pulse > 109 beats/min. Discrimination (AUC 0.847, 95% CI, 0.805-0.890) and calibration (Hosmer‒Lemeshow statistic, P = 0.142) were good in the derivation cohort and similar in the validation cohort (AUC 0.811, 95% CI, 0.755-0.868). The ABCDMP score had significantly better predictivity for in-hospital mortality than the BAP-65, CURB-65, DECAF, and NIVO scores (all P < 0.001). Additionally, the new score also had moderate predictive performance for 3-year mortality and can be used to stratify patients into different management groups.

Conclusions: The ABCDMP risk score could help predict mortality in AECOPD and CVDs patients and guide further clinical research on risk-based treatment.

Clinical trial registration: Chinese Clinical Trail Registry NO.:ChiCTR2100044625; URL: http://www.chictr.org.cn/showproj.aspx?proj=121626 .

Keywords: AECOPD; CVDs; Mortality; Risk score.

Publication types

Multicenter Study

MeSH terms

Aged
Cardiovascular Diseases* / diagnosis
Cohort Studies
Hospital Mortality
Humans
Prospective Studies
Pulmonary Disease, Chronic Obstructive*
Retrospective Studies
Risk Factors

Abstract

Publication types

MeSH terms

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