Comparing Modified DECAF and NEWS-2 Scores in Predicting In-Hospital Mortality in Acute Exacerbations of COPD

OBJECTIVE: To compare the performance of the modified DECAF and NEWS-2 scores in predicting in-hospital mortality among patients admitted with acute exacerbations of chronic obstructive pulmonary disease (AECOPD). STUDY DESIGN: A cross-sectional analytical study. Place and Duration of the Study: Department of Medicine, Aga Khan University Hospital, Karachi, Pakistan, from November 2023 to May 2024. METHODOLOGY: Seventy-nine patients with AECOPD were enrolled using a consecutive sampling technique. The modified DECAF and NEWS-2 scores were calculated at admission. Diagnostic accuracy was evaluated using sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). Receiver operating characteristic (ROC) analysis was performed to determine discriminatory power. RESULTS: The modified DECAF showed 100% sensitivity, 19.05% specificity, 77.33% PPV, and 100% NPV. NEWS-2 demonstrated 100% sensitivity, 22.22% specificity, 77.42% PPV, and 100% NPV. AUCs were 0.465 for the DECAF and 0.549 for the NEWS-2, indicating weak discriminative ability in this cohort. CONCLUSION: The Modified DECAF and NEWS-2 scores showed high sensitivity but low specificity and weak discriminatory power in predicting in-hospital mortality among patients with AECOPD. These findings suggested limited prognostic accuracy in this population and highlighted the need for larger multicentre studies for validation. KEY WORDS: Acute exacerbation, Chronic obstructive pulmonary disease, DECAF score, NEWS-2 score, In-hospital mortality, Predictive accuracy.