Abstract
BACKGROUND: Chronic obstructive pulmonary disease (COPD) exacerbations contribute significantly to increased morbidity, mortality, and healthcare costs, necessitating effective predictive tools for patient outcomes. The modified DECAF score (baseline dyspnea, eosinopenia, consolidation, acidemia, and frequency of hospitalization in the last year), neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR) are commonly evaluated for their predictive accuracy in COPD exacerbations. OBJECTIVE: This study aimed to compare the predictive accuracy of the modified DECAF score, NLR, and PLR in determining mortality and duration of hospital stay in patients with COPD exacerbations. METHODS: A prospective cohort study was conducted on 100 patients hospitalized with COPD exacerbations. Data on demographics, clinical history, and laboratory parameters were collected. The predictive performance of the modified DECAF score, NLR, and PLR was assessed using statistical analyses, including sensitivity, specificity, and multivariate regression. RESULTS: The modified DECAF score was significantly correlated with mortality (p < 0.01) and demonstrated superior predictive accuracy compared to NLR and PLR. While longer hospital stays were associated with higher modified DECAF scores, the correlations with NLR and PLR were not statistically significant. Environmental risk factors did not significantly impact mortality or the modified DECAF score. CONCLUSION: The modified DECAF score is a more reliable predictor of mortality and hospital stay duration in COPD exacerbations than NLR and PLR. Its implementation in clinical practice could enhance patient management by enabling better risk stratification. Further research is needed to validate these findings across diverse populations and explore the integration of genetic and epigenetic markers.