The following is a summary of “Can the Rome classification of chronic obstructive pulmonary disease exacerbation severity be applied in the hospital setting?,” published in the February 2024 issue of Pulmonology by Cometa, et al.

For a study, researchers sought to assess the applicability of the Rome proposal in classifying chronic obstructive pulmonary disease (COPD) exacerbations (ECOPDs) in various hospital settings, comparing it with conventional methods, determining the relationship between ECOPD severity and mortality, and analyzing outcomes across different hospital wards.

The observational retrospective study focused on patients admitted to the University Hospital of Ferrara (Italy) with a primary diagnosis of ECOPD in 2021. Data collected at admission included severity items from the Rome proposal, with a clinical-based score used to estimate missing Visual Analogue Scale (VAS) data on dyspnea.

Among 320 patients, the Rome proposal could classify ECOPD severity in 88.5% of cases. Of ECOPD admissions, 18.5% were mild, 50.5% were moderate, and 31% were severe. In-hospital mortality increased with ECOPD severity, with a 12-month mortality rate of 27% for mild ECOPD and 53.2% for severe ECOPD (P = 0.059). Severe ECOPDs were more common in patients admitted to Respiratory wards compared to Internal Medicine wards, with lower mortality rates observed in the former.

The Rome classification demonstrated applicability in hospital settings, aiding in better identifying the most suitable setting for ECOPD management. It also highlighted the association between ECOPD severity and mortality, emphasizing the importance of appropriate management strategies to improve patient outcomes.

Reference: resmedjournal.com/article/S0954-6111(23)00397-9/abstract