ArticleJournal of thoracic disease2026
Development and internal validation of a nomogram for predicting in-hospital mortality in patients with acute exacerbation of chronic obstructive pulmonary disease.
Article in Journal of thoracic disease, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Acute exacerbation of chronic obstructive pulmonary disease (AECOPD)-related in-hospital mortality poses a significant clinical challenge. Existing prognostic tools-including the DECAF (Dyspnoea, Eosinopenia, Consolidation, Acidaemia, and atrial Fibrillation) score, which requires eosinophil count and chest radiography, and the BAP-65 (Blood urea nitrogen, Altered mental status, Pulse rate, and age ≥65 years) score, which incorporates blood urea nitrogen measurement-depend on haematological or radiological investigations that may not be immediately available at admission. This study aims to develop a nomogram based on clinical admission variables and arterial blood gas analysis for early risk stratization in patients with AECOPD. Methods: This single-centre retrospective cohort study enrolled consecutive patients hospitalised for AECOPD between December 2016 and December 2018. Eligible patients had spirometry-confirmed COPD [post-bronchodilator forced expiratory volume in one second/forced vital capacity (FEV Results: Among 1,719 patients [75.6% male; median age 77.0 years, interquartile range (IQR): 69.0-84.0], 188 (10.9%) died during hospitalisation. Multivariable logistic regression (n=1,570) identified six independent predictors: older age [odds ratio (OR) =1.03, 95% confidence interval (CI): 1.02-1.05], higher modified Medical Research Council dyspnoea scale (mMRC) grade (OR =1.28, 95% CI: 1.05-1.56), lower peripheral oxygen saturation (SpO Conclusions: This internally validated nomogram integrates five clinical variables assessable without laboratory testing (age, mMRC grade, SpO
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