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Validation of the BAP-65 score for prediction of in-hospital death or use of mechanical ventilation in patients presenting to the emergency department with an acute exacerbation of COPD: a retrospective multi-center study from the Italian Society of Emergency Medicine (SIMEU)

Germini, Federico ; Veronese, Giacomo ; Marcucci, Maura ; Coen, Daniele ; Ardemagni, Deborah ; Montano, Nicola ; Fabbri, Andrea ; Adinolfi, Luigi Elio ; Alvisi, Antonella ; Antonio, Pagano ; Azin, Giulia ; Balloni, Andrea ; Bandiera, Geminiano ; Barchetti, Marco ; Barillari, Alfredo ; Barozzi, Marco ; Belloni, Giulia ; Belotti, Eugenia ; Binetti, Nicola ; Bonora, Miriam ; Bruni, Rosamaria ; Cacco, Silvia ; Camisa, Daniele ; Carbone, Giorgio ; Carpinteri, Giuseppe ; Catino, Laura ; Cazzaniga, Massimo ; Cenni, Patrizia ; Chelli, Vittorio ; Cicero, Leonora ; Cottone, Carlo Domenico ; Cuccia, Filippa ; D'Angelo, Luciano ; Dalmonte, Francesca ; Daviddi, Fabio ; De Vita, Anna ; Famà, Fausto ; Fedele, Marta ; Fonti, Caterina ; Frigerio, Marta ; Gallingani, Alan ; Ghiglione, Valeria ; Gioffrè-Florio, Maria ; Giordano, Mauro ; Giostra, Fabrizio ; Galli, Maria Giulia ; Greggi, Maria Elena ; Groff, Paolo ; Guizzardi, Stefano ; Lagasio, Chiara ; Lazzara, Giuseppe ; Lubini, Eloisa ; Magni, Laura ; Mancarella, Sandro ; Mangano, Giuseppe ; Maragno, Margherita ; Menabue, Monia ; Meoni, Eleonora ; Molinaro, Federica ; Morelli, Alice ; Moscariello, Francesco ; Nevola, Riccardo ; Noto, Paola ; Paladino, Fiorella ; Pancani, Roberta ; Petrelli, Giuseppina ; Petrino, Roberta ; Sinno, Carmine ; Tafa, Aferdita ; Tartaglia, Sergio ; Taurino, Chiara ; Treleani, Martina ; Villari, Liliana ; Vitelli, Alessandra ; Zaccagni, Cinzia ; Zaccaro, Bruna ; Zacchino, Massimo

European Journal of Internal Medicine, 03/2019, Vol.61, C, pp.62-68 [Rivista Peer Reviewed]

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  • Titolo:
    Validation of the BAP-65 score for prediction of in-hospital death or use of mechanical ventilation in patients presenting to the emergency department with an acute exacerbation of COPD: a retrospective multi-center study from the Italian Society of Emergency Medicine (SIMEU)
  • Autore: Germini, Federico ; Veronese, Giacomo ; Marcucci, Maura ; Coen, Daniele ; Ardemagni, Deborah ; Montano, Nicola ; Fabbri, Andrea ; Adinolfi, Luigi Elio ; Alvisi, Antonella ; Antonio, Pagano ; Azin, Giulia ; Balloni, Andrea ; Bandiera, Geminiano ; Barchetti, Marco ; Barillari, Alfredo ; Barozzi, Marco ; Belloni, Giulia ; Belotti, Eugenia ; Binetti, Nicola ; Bonora, Miriam ; Bruni, Rosamaria ; Cacco, Silvia ; Camisa, Daniele ; Carbone, Giorgio ; Carpinteri, Giuseppe ; Catino, Laura ; Cazzaniga, Massimo ; Cenni, Patrizia ; Chelli, Vittorio ; Cicero, Leonora ; Cottone, Carlo Domenico ; Cuccia, Filippa ; D'Angelo, Luciano ; Dalmonte, Francesca ; Daviddi, Fabio ; De Vita, Anna ; Famà, Fausto ; Fedele, Marta ; Fonti, Caterina ; Frigerio, Marta ; Gallingani, Alan ; Ghiglione, Valeria ; Gioffrè-Florio, Maria ; Giordano, Mauro ; Giostra, Fabrizio ; Galli, Maria Giulia ; Greggi, Maria Elena ; Groff, Paolo ; Guizzardi, Stefano ; Lagasio, Chiara ; Lazzara, Giuseppe ; Lubini, Eloisa ; Magni, Laura ; Mancarella, Sandro ; Mangano, Giuseppe ; Maragno, Margherita ; Menabue, Monia ; Meoni, Eleonora ; Molinaro, Federica ; Morelli, Alice ; Moscariello, Francesco ; Nevola, Riccardo ; Noto, Paola ; Paladino, Fiorella ; Pancani, Roberta ; Petrelli, Giuseppina ; Petrino, Roberta ; Sinno, Carmine ; Tafa, Aferdita ; Tartaglia, Sergio ; Taurino, Chiara ; Treleani, Martina ; Villari, Liliana ; Vitelli, Alessandra ; Zaccagni, Cinzia ; Zaccaro, Bruna ; Zacchino, Massimo
  • Note di contenuto: Keywords Pulmonary disease; Chronic obstructive; Prognosis; Emergency service, Hospital; Risk Highlights * Patients with COPDE are at risk of adverse short-term clinical outcome. * The BAP-65 score has been proposed for the prediction of mortality and use of IMV. * We validated the prognostic performance of the score in the ED setting. * The BAP-65 tool is not sufficiently accurate for risk prediction in ED patients with COPDE. Abstract Exacerbations of chronic obstructive pulmonary disease (COPDE) frequently require hospitalizations, may necessitate of invasive mechanical ventilation (IMV), and are associated with a remarkable in-hospital mortality. The BAP-65 score is a risk assessment model (RAM) based on simple variables, that has been proposed for the prediction of these adverse outcomes in patients with COPDE. If showed to be accurate, the BAP-65 RAM might be used to guide the patients management, in terms of destination and treatment. We conducted a retrospective, multicentre, chart-review study, on patients attending the ED for a COPDE during 2014. The aim of the study was the validation of the BAP-65 RAM for the prediction of in-hospital death or use of IMV (composite primary outcome). We assessed the discrimination and the prognostic performance of the BAP-65 RAM. We enrolled 2908 patients from 20 centres across Italy. The mean (standard deviation) age was 76 (11) years, and 38% of patients were female. The composite outcome occurred in 5.3% of patients. The AUROC of BAP-65 for the composite outcome was 0.64 (95%CI 0.59--0.68). The sensitivity of BAP-65 score [greater than or equal to] 4 to predict in-hospital mortality was 44% (95% CI 34%--55%), the specificity was 84% (95% CI 82%--85%), the positive predictive value was 9% (95% CI 6%--12%), and the negative predictive value was 98% (95% CI 97%--98%). Conclusions In patients attending Italian EDs with a COPDE, we found that the BAP-65 score did not have sufficient accuracy to stratify patients upon their risk of severe in-hospital outcomes. Author Affiliation: (a) Universita della Campania Luigi Vanvitelli, Dipartimento di Scienze Mediche, Chirurgiche, Neurologiche, Metaboliche e dell'Invecchiamento, Ospedale Clinicizzato di Marcianise, Marcianise (CE), Italy (b) Pronto Soccorso e Medicina D'urgenza, Ospedale Civile di Vignola AUSL, Modena, Italy (c) U.O.C Ps-OBI A.O.R.N A, Cardarelli di Napoli, Italy (d) Dipartimento di Scienza della Salute, Universita degli studi di Milano Bicocca, Italy (e) Pronto Soccorso Ospedale A. Murri, Fermo, Italy (f) Pronto Soccorso OCSAE--Azienda Ospedaliero Universitaria Policlinico OCSAE, Modena, Italy (g) Nuovo Ospedale di Sassuolo, Modena, Italy (h) Pronto Soccorso, AAS2 Bassa Friulana-Isontina, Ospedale di Monfalcone (Go), Italy (i) U.O. Medicina d'Urgenza-Pronto Soccorso, Presidio Ospedaliero "Bufalini-Marconi-Angiloni", Cesena, Italy (j) Geriatria, Fondazione IRCCS Ca' Granda -- Ospedale Maggiore Policlinico, Milano, Italy (k) Emergenza Alta Specializzazione (Pronto soccorso), ASST Papa Giovanni XXIII di Bergamo, Italy (l) Unita Operativa di Pronto Soccorso ed Emergenza territoriale, Area Nord Bologna, Italy (m) Pronto Soccorso e Medicina d'Urgenza, Ospedale Madonna delle Grazie, Matera, Italy (n) Pronto Soccorso ospedale San Martino, Belluno, Italy (o) Pronto Soccorso, ASST Melegnano e Martesana, Presidio di Vizzolo Predabissi, Milano, Italy (p) Pronto Soccorso, ASST Melegnano e Martesana, Presidio di Vizzolo Predabissi, Milano, Italy (q) S.C. di Medicina e Chirurgia d'Urgenza e Accettazione, Humanitas "Gradenigo", Torino, Italy (r) Azienda Ospedaliero Universitaria Policlinico Vittorio Emanuele, Catania, Italy (s) Universita degli Studi di Modena e Reggio Emilia, Italy (t) Pronto Soccorso, Ospedale A. Manzoni, Azienda Ospedaliera di Lecco, Lecco, Italy (u) Pronto Soccorso e Medicina d'Urgenza, Ospedale di Imola (BO), Italy (v) Dipartimento di Emergenza e Accettazione, Presidio Grosseto, Azienda Usl Toscana sud est, Italy (w) U.O. Medicina d'Urgenza-Pronto Soccorso, Presidio Ospedaliero "Bufalini-Marconi-Angiloni", Cesena, Italy (x) Responsabile PS, Ospedale di Petralia Sottana (PA), Italy (y) Pronto Soccorso e Medicina d'Urgenza, Ospedale Madonna delle Grazie, Matera, Italy (z) Pronto Soccorso e Medicina d'Urgenza, Ospedale di Imola (BO), Italy (aa) Medicina d'Accettazione e d'Urgenza P.O. Pescia (PT), Italy (ab) Universita della Campania Luigi Vanvitelli, Dipartimento di Scienze Mediche, Chirurgiche, Neurologiche, Metaboliche e dell'Invecchiamento, Ospedale Clinicizzato di Marcianise, Marcianise (CE), Italy (ac) Human Pathology Department, University Hospital "G. Martino" of Messina, Messina, (Italy) (ad) Unita Operativa di Pronto Soccorso ed Emergenza territoriale, Area Nord Bologna, Italy (ae) Pronto Soccorso Ospedale A. Murri, Fermo, Italy (af) Nuovo Ospedale di Sassuolo, Modena, Italy (ag) Pronto Soccorso, Ospedale S. Paolo, Savona, ASL 2, Liguria, Italy (ah) Dipartimento di Medicina Clinica e Sperimentale, Universita degli Studi di Parma, Parma, Italy (ai) UO Pronto Soccorso e Medicina d'Urgenza, Ospedale "Madonna del Soccorso", San Benedetto del Tronto, Italy (aj) Pronto Soccorso, Ospedali riuniti Padova Sud Madre Teresa di Calcutta, Azienda ULSS 6 Euganea, Schiavonia, Padova, Italy (ak) Pronto Soccorso, AAS2 Bassa Friulana-Isontina, Ospedale di Monfalcone (Go), Italy (al) Pronto Soccorso, ASST di Vimercate, Ospedale di Vimercate (MB), Italy (am) Pronto Soccorso, Ospedale Bassini, Cinisello Balsamo, ASST-Nord Milano, Italy (an) Pronto Soccorso e Medicina D'urgenza, Ospedale Civile di Vignola, AUSL, Modena, Italy (ao) Pronto Soccorso, Medicina D'Urgenza e 118--Ospedale Morgagni-Pierantoni di Forli, Italy (ap) Pronto soccorso e medicina d'urgenza Pordenone, Italy (aq) U.O.C Ps-OBI A.O.R.N A. Cardarelli di Napoli, Italy (ar) Medicina e Chirurgia d'accettazione e d'urgenza Azienda USL Toscana Nordovest, Italy (as) Medicina e Chirurgia d'Accettazione ed Urgenza (MeCAU)--Pronto Soccorso, Ospedale S. Andrea, Vercelli, Italy (at) Dipartimento di Scienza della Salute, Universita degli studi di Milano Bicocca, Italy (au) Department of Health Research Methods, Evidence, and Impact (formerly Clinical Epidemiology and Biostatistics), McMaster University, Hamilton, ON, Canada (av) Department of Health Sciences, Universita degli Studi di Milano, Milan, Italy (aw) Emergency Department, Fondazione IRCCS Ca' Granda -- Ospedale Maggiore Policlinico, Milan, Italy (ax) Department of Emergency Medicine, Grande Ospedale Metropolitano Niguarda Ca' Granda, Universita di Milano-Bicocca, Milan, Italy (ay) Geriatric Unit, Fondazione IRCCS Ca' Granda -- Ospedale Maggiore Policlinico, Milan, Italy (az) Department of Clinical Sciences and Community Health, Universita degli Studi di Milano, Milan, Italy (ba) Department of Emergency Medicine, Ospedale Morgagni-Pierantoni, Forli, Italy * Corresponding author at: Department of Health Research Methods, Evidence, and Impact, McMaster University, 1280 Main St. W., Hamilton ON L8S 4K1, Canada. Article History: Received 4 August 2018; Revised 7 October 2018; Accepted 24 October 2018 Byline: Federico Germini [federicogermini@gmail.com] (au,av,aw,*), Giacomo Veronese (ax), Maura Marcucci (au), Daniele Coen (ax), Deborah Ardemagni (ay,az), Nicola Montano (aw,az), Andrea Fabbri (ba), Luigi Elio Adinolfi (a), Antonella Alvisi (b), Pagano Antonio (c), Giulia Azin (d), Andrea Balloni (e), Geminiano Bandiera (f), Marco Barchetti (g), Alfredo Barillari (h), Marco Barozzi (i), Giulia Belloni (j), Eugenia Belotti (k), Nicola Binetti (l), Miriam Bonora (m), Rosamaria Bruni (n), Silvia Cacco (o), Daniele Camisa (p), Giorgio Carbone (q), Giuseppe Carpinteri (r), Laura Catino (s), Massimo Cazzaniga (t), Patrizia Cenni (u), Vittorio Chelli (v), Leonora Cicero (w), Carlo Domenico Cottone (x), Filippa Cuccia (y), Luciano D'Angelo (t), Francesca Dalmonte (z), Fabio Daviddi (aa), Anna De Vita (ab), Fausto Fama (ac), Marta Fedele (ad), Caterina Fonti (q), Marta Frigerio (ae), Alan Gallingani (af), Valeria Ghiglione (ag), Maria Gioffre-Florio (ac), Mauro Giordano (ab), Fabrizio Giostra (ae), Maria Giulia Galli (ah), Maria Elena Greggi (x), Paolo Groff (ai), Stefano Guizzardi (aj), Chiara Lagasio (ag), Giuseppe Lazzara (aj), Eloisa Lubini (ak), Laura Magni (al), Sandro Mancarella (am), Giuseppe Mangano (r), Margherita Maragno (y), Monia Menabue (an), Eleonora Meoni (aa), Federica Molinaro (q), Alice Morelli (ao), Francesco Moscariello (ap), Riccardo Nevola (ab), Paola Noto (r), Fiorella Paladino (aq), Roberta Pancani (ar), Giuseppina Petrelli (ai), Roberta Petrino (as), Carmine Sinno (y), Aferdita Tafa (v), Sergio Tartaglia (as), Chiara Taurino (ar), Martina Treleani (ap), Liliana Villari (ar), Alessandra Vitelli (aq), Cinzia Zaccagni (am), Bruna Zaccaro (y), Massimo Zacchino (at)
  • Fa parte di: European Journal of Internal Medicine, 03/2019, Vol.61, C, pp.62-68
  • Soggetti: Chronic Obstructive Lung Disease – Usage ; Chronic Obstructive Lung Disease – Analysis ; Professional Associations – Usage ; Professional Associations – Analysis ; Hospital Emergency Services – Usage ; Hospital Emergency Services – Analysis ; Emergency Medicine – Usage ; Emergency Medicine – Analysis
  • Lingua: Inglese
  • Tipo: Articolo
  • Identificativo: ISSN: 09536205 ; DOI: http://dx.doi.org/10.1016/j.ejim.2018.10.018

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