Siti TF Lubis1, EN Keliat1, Alwinsyah Abidin1
1Divisi Pulmonologi dan Alergi Imunologi, Departemen Ilmu Penyakit Dalam, FK USU/RSUP H. Adam Malik, Medan

ABSTRACT
Background: The assessment of severity in acute exacerbation of chronic obstructive pulmonary disease (AECOPD) at early admission is important to determine the risk of in-hospital mortality, the need of hospitalization or requirement of intensive care unit and further management. Two scoring systems, DECAF (Dyspnea, Eosinopenia, Consolidation, Acidaemia, Atrial Fibrillation) and BAP-65 (elevated BUN, Altered mental status, Pulse 109 beats/min, age >65 years were developed as prognostic tools.
Objective: To compare the sensitivity and specificity of DECAF scoring and BAP-65 scoring in predicting 30-days mortality in AECOPD patients.
Methods: A cohort study was conducted on patients in Emergency Unit and in-patients with AECOPD in H. Adam Malik Hospital, Medan, from February to June 2013. Both DECAF scores and BAP-65 scores were assessed. The sensitivity and specificity of both scorings were compared to determine the more accurate predictor. Results: A total of 40 subjects were recruited with mean age of 61,07 ± 12,42 years old. Nine subjects died during the study. Chi-square test showed that both scoring systems were significantly related to 30-days mortality, with p=0,003 for DECAF scoring and p=0,002 for BAP-65 scoring. The sensitivity and specificity of DECAF scoring are 100% and 16%, while those of BAP-65 scoring are 100% and 39%, respectively.
Conclusion: Both DECAF scoring and BAP-65 scoring have significant correlation with 30-days mortality in AECOPD patients. Both scoring systems have high sensitivity. However, low specificity renders both systems unfitting as predictor tools.
Key words: Acute exacerbation, COPD, BAP-65 score, DECAF score, predictor.