Predictive score for in-hospital mortality in patients with severe AECOPD

<bold>Introduction:</bold> Patients with severe acute exacerbations of chronic obstructive pulmonary disease (AECOPD) often have a poor prognosis. <bold>Objectives:</bold> Assessing the risk of death in patients with severe AECOPD helps clinicians select appropriate treatment and improve patient prognosis. <bold>Methods:</bold> Patients hospitalized for severe AECOPD were consecutively included. All patients were randomly assigned to the developmental and validation cohorts in a 7:3 ratio. We identified independent prognostic factors for in-hospital mortality in the development cohort by univariate analysis and multivariate logistic regression analysis. In the validation cohort, we validated the predictive power of the new score and compared it with the other four scores. <bold>Results:</bold> A total of 488 patients with severe AECOPD who were hospitalized from January 2011 to October 2022 were included. Of these patients, 361 (74.0%) were male with a mean age of 78.0 ± 8.2 years. The development cohort included 342 patients, 40 of whom died during hospitalization. The five independent risk factors associated with in-hospital mortality according to multifactorial regression analysis were WBC >10×109/L , lymphocyte count <0.8×109/L , age >80 years, altered consciousness, and chronic heart failure. In the validation cohort, the new prediction scores had excellent predictive power (AUC=0.826, 95%CI: 0.724-0.928) and performed more strongly than other clinical prediction scores. <bold>Conclusions:</bold> The new predictive score is a simple and effective method for predicting mortality in hospitalized patients with severe AECOPD and can help clinicians more accurately predict patients' conditions and select appropriate treatments to improve their prognosis.