Pneumonia Severity Index and CURB-65 score as a Predictor of In-Hospital Mortality in Acute Exacerbation of COPD

Aim and Objective To investigate the role of Pneumonia Severity Index (PSI) and confusion, Urea, Respiratory Rate, Blood Pressures core (CURB-65) in Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disorder with Reference to Mortality Methods In our study a total of 100 patients of COPD with acute exacerbation were included in the study from tertiary care centre, Kolkata for a period of 12 months from December 2015 to November 2016. Results In our study, overall in hospital mortality was 21 %, while mortality in age groups 50-65, 66-80 and greater than80 were respectively 3.3 %, 28.3 % and 29.41 %. Hence advanced age was associated with significant increase in mortality. The mortality among risk classes of PSI like II, III, IV and V was respectively 0 %, 0 %, 22.22 % and 78.57 % respectively. The percentage of mortality increased significantly as the PSI score increases (p value ≤ 0.001). The mortality associated with the low, intermediate, and high risk classes of CURB-65 was respectively 4.17 %, 14 % and 50 %. Mortality increased with an increase in score demonstrating a significant relation between the two (p value = 0.006). Conclusion Chronic obstructive pulmonary disease (COPD) is a global public health problem and a significant cause of chronic morbidity and mortality worldwide. Infectious are at least 75-80 % of acute COPD exacerbations. Our study detected 21 % in-hospital mortality. A PSI score of greater than130 i. e. risk class V as well as CURB-65 score of more than equal to 3 i. e. group 3, were strong predictors of in-hospital mortality.