The following is a summary of “Value of integrated pulmonary index to predict exacerbation of chronic obstructive pulmonary Disease’s severity,” published in the September 2023 issue of Emergency Medicine by Karaarslan, et al.

For a study, researchers sought to investigate the correlation between current prognostic scores and the Integrated Pulmonary Index (IPI) in patients presenting to the emergency department (ED) with exacerbation of chronic obstructive pulmonary disease (COPD). Additionally, it examined the diagnostic utility of combining the IPI with other scores to identify patients who can be safely discharged.

Conducted as a multicenter prospective observational study from August 2021 to June 2022, the research included patients diagnosed with COPD exacerbation (eCOPD) in the ED. These patients were categorized according to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) classification. Various scores, including CURB-65 (Confusion, Urea, Respiratory rate, Blood pressure, and age older than 65 years), BAP-65 (Blood urea nitrogen, Altered mental status, Pulse rate, and age older than 65 years), DECAF (Dyspnea, Eosinopenia, Consolidation, Academia, and Atrial Fibrillation) scores, and IPI values were recorded. The study assessed the correlation between the IPI and other scores, as well as the diagnostic value of using the IPI to identify mild eCOPD. Furthermore, the study explored the diagnostic value of CURB-IPI, a newly devised score that combines CURB-65 and IPI, in mild eCOPD.

The study enrolled 110 patients (49 females and 61 males) with an average age of 67 (ranging from 40 to 97). IPI and CURB-65 demonstrated better predictive value in identifying mild exacerbations compared to DECAF and BAP-65 scores (with respective Area under Curves (AUC) of 0.893, 0.795, 0.735, and 0.541). Notably, the CURB-IPI score exhibited the highest predictive value for detecting mild exacerbations (AUC 0.909).

The Integrated Pulmonary Index (IPI) was found to possess substantial predictive value in detecting mild COPD exacerbations. Its predictive capacity was further enhanced when combined with CURB-65. The CURB-IPI score can serve as a valuable tool in determining whether patients with COPD exacerbation can be safely discharged.

Source: sciencedirect.com/science/article/abs/pii/S0735675723002930