REPOCUR: thyrty-day risk model in adult patients with acute exacerbation of chronic obstructive pulmonary disease (COPD) discharged from the emergency department

Objective.

Design a risk model to predict adverse outcome (AO) 30 days after discharge in adult patients treated for acute exacerbation (AE) of chronic obstructive pulmonary disease (COPD) in emergency departments (EDs).

Method.

PREURG was a prospective, observational, multi-purpose, multicenter cohort registry. Phone calls were made as part of a 30-day follow-up. The main variable was the presence of any AO (recurrence of COPD AE, ED revisit, hospitalization, institutionalization, or death) 30 days after being discharge from the ED.

Results.

The study included a total of 931 patients with COPD AE (23.4% women and 76.6% men) discharged from the ED with follow-up data; 322 (34.6%) had an AO 30 days after being discharge from the ED. The REPOCUR model included the variable sex (OR for men of 1.50 [95%CI, 1.06-2.15]), severe COPD AE type (OR, 3.15 [95%CI, 2.02-5.04]), $ 2 COPD AE/year (OR, 1.64 [95%CI, 1.20-2.24]), and $ 4 ED visits/year (OR, 2.15 [95%CI, 1.52-3.04]). Each item is worth 1 point. The risk of experiencing an AO at 30 days with a score of 1 is 22.5%; 35.0% with a score of 2; 50.0% with a score of 3; and 65.1% with a score of 4. The area under the curve is 0.67 (95%CI,
0.64-0.71).

Conclusions.

The REPOCUR model could be a useful prognostic tool to identify adult patients with COPD AE and a high risk of exhibing AO at 30 days after being discharged from the emergency department.