A Real-Life Validation of the Rome Proposal: Does the Setting Matter?

<bold>Background:</bold> The Rome proposal aims to assess the severity of COPD exacerbations (ECOPD) by using objective parameters. Several retrospective studies have tested this scale of severity in real-life hospital settings. <bold>Aims:</bold> This study aimed to evaluate the influence of the ward of hospitalization (Internal Medicine [MW] vs Respiratory [RW] wards) on relevant clinical outcomes of hospitalized ECOPD. <bold>Methods:</bold> We retrospectively enrolled 533 ECOPD hospitalized patients at University Hospital of Ferrara with a primary diagnosis of ECOPD. ECOPD severity was assessed using the Rome proposal, with resting dyspnoea as a proxy for VAS>5. <bold>Results:</bold> ECOPD severity (with respective 6 months and 12 months mortality) according to the Rome score was distributed as follows: mild n=148 (17%; 24%), moderate n=251(30%; 38%), and severe n=134 (32%; 45%). A higher proportion of patients admitted to PW was severe compared to those admitted to MW (33% vs. 21%; p=0.0014). Mortality rates differed significantly between wards at 6 months (p=0.043), for severe patients it was of 34,5% in MW vs. 28,3% in PW. Charlson Comorbidity Index was slightly higher in MW patients (median 7, IQR 5-9) compared to PW (median 6, IQR 4-7); p<0.0001. <bold>Conclusions:</bold> The Rome proposal offers valuable insights into ECOPD severity and prognosis. However, incorporating additional factors, such as comorbidities and clinical settings, could enhance its predictive value. <fig><object-id>erj;66/suppl_69/PA4680/F1</object-id><object-id>F1</object-id><object-id>F1</object-id><graphic></graphic></fig>