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Master Thesis

Performance des scores pronostiques des exacerbations de bronchopneumopathie chronique obstructive pour prédire le recours aux soins délivrés uniquement en milieu hospitalier

Abstract : Introduction. More than half of patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) are admitted to the emergency department. However, 50% of these patients have a low mortality suggesting that ambulatory care may be possible. The CURB 65, BAP65 and DECAF scores were constructed and validated to predict the outcome of patients admitted for AECOPD. Our objective was to assess the performance of these scores to predict the consumption of hospital medical resources. Method. This is an ancillary study of the ExaDOM research protocol (NCT03474575) carried out at the CHU Grenoble Alpes, the objective of which is to evaluate a protocol for home care of AECOPD. For this ancillary work, we specifically collected the need for mandatory hospitalization defined by the consumption of care available only in hospitals. We calculated the sensitivity, specificity and area under the ROC curve to study the predictive value of the prognostic scores. Results. Two hundred hospitalized patients were included, 72 (36%) women and 128 (64%) men. The age of the patients was 76 [67 - 85] years. Sixty five (32%) patients required mandatory hospitalization and the use of purely hospital resources. Among the prognostic scores, the BAP65 score presented the best performance in predicting the use of purely hospital resources, the area under the curve being mediocre (0.63 95% CI [0.54 - 0.72]). Conclusion. The BAP65, CURB65 and DECAF scores do not perform well in predicting the consumption of purely hospital resources during AECOPD.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-02932966
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Submitted on : Tuesday, September 8, 2020 - 9:27:36 AM
Last modification on : Tuesday, November 24, 2020 - 4:00:13 PM

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Amandine Barazzutti. Performance des scores pronostiques des exacerbations de bronchopneumopathie chronique obstructive pour prédire le recours aux soins délivrés uniquement en milieu hospitalier. Médecine humaine et pathologie. 2020. ⟨dumas-02932966⟩

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