COPD Exacerbation Risk Stratification Score - Equation

Description

Niewoehner et al developed a score for predicting exacerbations in a patient with chronic obstructive pulmonary disease (COPD). This can help identify a patient who may benefit from more aggressive management. The authors are from multiple Veterans Affairs hospitals across the United States.

Parameters:

(1) age of the patient in years

(2) observed FEV1 as percent of predicted

(3) productive cough

(4) theophylline therapy at entry

(5) duration of COPD in years

(6) course of antibiotics for COPD during the prior year

(7) number of courses of systemic steroids for COPD during the prior year

(8) hospital admissions for COPD during the prior year

Parameter	Finding	Points
age of the patient in years	< 45 years	0
	45 to 54 years	20
	55 to 64 years	40
	65 to 74 years	60
	75 to 84 years	80
	>= 85 years	100
FEV1 as percent of predicted	10 to 19%	75
	20 to 29%	66
	30 to 39%	56
	40 to 49%	47
	50 to 59%	38
	60 to 69%	28
	>= 70%	0
productive cough	absent	0
	present	31
theophylline therapy at entry	no	0
	yes	26
duration of COPD	1 year	0
	2 years	5
	3 years	9
	4 years	14
	5 years	19
	6 years	23
	7 years	28
	>= 8 years	33
course of antibiotics for COPD	0	0
	>= 1	63
courses of systemic steroids	0	0
	1	39
	>= 2	70
hospital admissions	0	0
	>= 1	24

where:

• An FEV1 < 10% of predicted is probably incompatible with life. An FEV1 >= 70% of predicted can be handled in several ways. For the implementation I set it to 0.

total score =

= SUM(points for all 8 parameters)

Interpretation:

• minimum score: 0

• maximum score: 422

• The higher the score the greater the risk of an exacerbation of the COPD.

Total Score	Percent probability of an exacerbation within 6 months
< 50	< 7%
50 to 250	(0.000444 * ((points)^2)) + (0.01629 * (points)) + 5.946
250 to 425	(-0.000148 * ((points)^2)) + (0.4008 * (points)) - 53.54

To read more or access our algorithms and calculators, please log in or register.

Description

Specialty

Objective

ICD-10

Exacerbation Risk Score of Niewoehner et al for a Patient with Chronic Obstructive Pulmonary Disease (COPD)

Purpose: To evaluate a patient with moderate to severe COPD for the risk of exacerbation using the score of Niewoehner et al.

Description

Specialty

Objective

ICD-10