title: Prediction of hospitalization stay in COPD exacerbations: the AECOPD-F score.
abstract: BACKGROUND
  Hospital admissions for COPD exacerbations account for 70% of total costs of COPD treatment, and the duration of hospital stay is directly related to this cost. The aim of this study was to investigate possible associations of demographic, clinical, laboratory, and functional parameters with stay of subjects admitted for COPD exacerbations and to provide a score for the prediction of the need for prolonged hospitalization.
  
  
  METHODS
  We included 164 consecutive subjects admitted to 2 respiratory medicine departments of 2 tertiary hospitals for a COPD exacerbation, and we evaluated laboratory, clinical, and functional parameters possibly related to the duration of hospital stay.
  
  
  RESULTS
  Seven parameters evaluated on subject admission (Antonisen type of exacerbation, number of Exacerbations in the previous year, Charlson index of comorbidities, Oxygenation, Partial pressure of P(aCO2) in arterial blood gases, Dyspnea according to the Borg dyspnea scale, and history of chronic respiratory Failure) were able to predict stay and were included in a simple score named AECOPD-F. The area under the curve of the score for the prediction of prolonged hospital stay is 0.960, and a cutoff point ≥ 3 predicts prolonged stay with a sensitivity of 84.5% and a specificity of 92.5% (95% CI 0.917-0.984). The AECOPD-F score was validated in a second group of 88 subjects admitted to the hospital for a COPD exacerbation. In the validation group, subjects with a score ≥ 3 required prolonged stay compared with those with a score < 3 (8.0 [6.0-10.0] vs 6.5 [4.0-9.0] d, respectively, P = .007).
  
  
  CONCLUSIONS
  The AECOPD-F score could accurately predict stay in hospitalized COPD subjects. The implementation of this score in clinical practice could be useful in the discharge planning of such subjects.
authors: Third Respiratory Medicine Department, Sismanogleio General Hospital, Athens, Greece. fdiamantea2001@yahoo.co.uk.
authors: Filia
authors: F
authors: Diamantea
authors: Second Respiratory Medicine Department, University of Athens Medical School, Athens, Greece.
authors: Konstantinos
authors: K
authors: Kostikas
authors: Respiratory Medicine Department, Amalia Fleming General Hospital, Athens, Greece.
authors: Konstantinos
authors: K
authors: Bartziokas
authors: Third Respiratory Medicine Department, Sismanogleio General Hospital, Athens, Greece.
authors: Foteini
authors: F
authors: Karakontaki
authors: Third Respiratory Medicine Department, Sismanogleio General Hospital, Athens, Greece.
authors: Stamatoula
authors: S
authors: Tsikrika
authors: Third Respiratory Medicine Department, Sismanogleio General Hospital, Athens, Greece.
authors: Sofia
authors: S
authors: Pouriki
authors: Third Respiratory Medicine Department, Sismanogleio General Hospital, Athens, Greece.
authors: Vlassis
authors: V
authors: Polychronopoulos
authors: Third Respiratory Medicine Department, Sismanogleio General Hospital, Athens, Greece.
authors: Napoleon
authors: N
authors: Karagiannidis
authors: Respiratory Medicine Department, Amalia Fleming General Hospital, Athens, Greece.
authors: Aikaterini
authors: A
authors: Haniotou
authors: Third Respiratory Medicine Department, Sismanogleio General Hospital, Athens, Greece.
authors: Andriana I
authors: AI
authors: Papaioannou
mesh_terms: D000368:Aged; D017281:Cost of Illness; D018450:Disease Progression; D005260:Female; D006801:Humans; D007902:Length of Stay / Q000191:economics / Q000639:trends*; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011379:Prognosis; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis / Q000191:economics / Q000628:therapy*; D012189:Retrospective Studies
keywords: COPD exacerbation; comorbidities; duration of hospital stay; dyspnea; predictors of outcomes