The DECAF score: Predicting hospital mortality in exacerbations of COPD
Despite exacerbations of chronic obstructive pulmonary disease (COPD) being both common and often fatal, accurate prognostication of patients hospitalised with an exacerbation is difficult. For exacerbations complicated by pneumonia, the CURB-65 prognostic tool is frequently used but its use in this population is suboptimal.

The DECAF Score is a simple yet effective predictor of mortality in patients hospitalised with an exacerbation of COPD and has the potential to help clinicians more accurately predict prognosis, and triage place and level of care to improve outcome in this common condition.
Research authors: John Steer, John Gibson, Stephen C. Bourke
Details Formula Study characteristics Files & References
Model author
Model ID
Revision date
MeSH terms
  • Chronic Obstructive Pulmonary Disease
  • Disease Exacerbation
  • Model type
    Custom model (Conditional)
    Condition Formula

    Additional information

    Consecutive patients hospitalised with an exacerbation of COPD were recruited. Admission clinical data and inhospital death rates were recorded. Independent predictors of outcome were identified by logistic regression analysis and incorporated into a clinical prediction tool.

    Study Population

    Total population size: 920
    Males: {{ model.numberOfMales }}
    Females: {{ model.numberOfFemales }}

    Continuous characteristics

    Name Mean SD Unit
    Age 73.1 10 Years
    FEV1 43.6 17.2 % predicted
    FVC 2.15 0.8 litre
    Name LL Q1 Median Q3 UL Unit
    Smoking burden 32 45 60 Cigarette pack years
    No. of hospital admissions in previous year 0 0 1 Admissions
    No. of AECOPD in previous year 1 3 4 AECOPD
    eMRCD 4 4 5 score

    Categorical characteristics

    Name Subset / Group Nr. of patients
    Institutional care No 860
    Yes 60
    Living independently No 211
    Yes 709
    Housebound No 605
    Yes 315
    Long-term oxygen therapy No 806
    Yes 114
    Previous admission requiring NIV No 820
    Yes 100
    Cor pulmonale No 92
    Yes 828
    Long-term prednisolone No 84
    Yes 836
    Home nebulised therapy No 767
    Yes 153
    Comorbidity Cerebrovascular disease 129
    Ischaemic heart disease 270
    Hypertension 364
    Diabetes 136
    Atrial Fibrillation 115
    Left ventricular dysfunction 67
    Chronic kidney disease 62
    Cognitive impairment 50
    Purulent sputum No 472
    Yes 448
    Ineffective cough No 109
    Yes 811
    Pedal oedema No 255
    Yes 565
    Acute confusion No 804
    Yes 116
    The DECAF score: Predicting hospital mortality in exacerbations of COPD
    Refer to Intended Use for instructions before use
    Evidencio B.V., Irenesingel 19, 7481 GJ, Haaksbergen, the Netherlands

    Related files

    No related files available

    Risk of in-hospital mortality is:

    {{ resultSubheader }}

    {{ model.survival.PITTitle }}

    {{ model.survival.YNETitle }}

    Notes are only visible in the result download and will not be saved by Evidencio

    Risk of in-hospital mortality is: %

    {{ resultSubheader }}
    {{ chart.title }}

    Outcome stratification

    Result interval {{ additionalResult.min }} to {{ additionalResult.max }}

    Conditional information

    Result interpretation

    This simple clinical prediction tool, incorporating indices routinely available at the time of hospital admission, can accurately stratify patients hospitalised with AECOPD into clinically relevant risk categories and could therefore assist clinicians managing this frequently fatal condition.

    The predicted mortality risk is based on the risks reported on external validation by Echevarria et al: Validation of the DECAF score to predict hospital mortality in acute exacerbations of COPD

    {{ file.classification }}

    Calculations alone should never dictate patient care, and are no substitute for professional judgement. See our full disclaimer.

    Please enter a comment of rating
    Comments are visible to anyone

    Model feedback

    No feedback yet 1 Comment {{ model.comments.length }} Comments
    Not rated | On {{ comment.created_at }} {{ comment.user.username }} a no longer registered author wrote:

    Please sign in to enable Evidencio print features

    In order to use the Evidencio print features, you need to be logged in.
    If you don't have an Evidencio Community Account you can create your free personal account at:

    Printed results - Examples {{ new Date().toLocaleString() }}

    Evidencio Community Account Benefits

    With an Evidencio Community account you can:

    • Create and publish your own prediction models.
    • Share your prediction models with your colleagues, research group, organization or the world.
    • Review and provide feedback on models that have been shared with you.
    • Validate your models and validate models from other users.
    • Find models based on Title, Keyword, Author, Institute, or MeSH classification.
    • Use and save prediction models and their data.
    • Use patient specific protocols and guidelines based on sequential models and decision trees.
    • Stay up-to-date with new models in your field as they are published.
    • Create your own lists of favorite models and topics.
    A personal Evidencio account is free, with no strings attached! Join us and help create clarity, transparency, and efficiency in the creation, validation, and use of medical prediction models.

    Disclaimer: Calculations alone should never dictate patient care, and are no substitute for professional judgement.