Predictive value of PSI and CURB-65 scores for short-term re-exacerbation in patients with AECOPD after remission

LIU Wei-nan; WANG Shi-han; SUN Cong

doi:10.13820/j.cnki.gdyx.20250038

Abstract：Objective To construct a predictive model for short-term re-exacerbation in patients with acute ex-acerbation of chronic obstructive pulmonary disease(AECOPD)after remission,based on the pneumonia severity index(PSI)and the confusion,urea,respiratory rate,blood pressure,and age ≥ 65(CURB-65)score,and to evaluate the predictive value of these scores.Methods A total of 200 AECOPD patients admitted between October 2022 and October 2024 were prospectively enrolled.Based on whether acute exacerbation occurred within 30 days after remission,patients were divided into a re-exacerbation group and a non-exacerbation group.Clinical data,PSI scores,and CURB-65 scores were collected.Univariate analysis was used to identify factors associated with short-term re-exacerbation,and binary logistic regression was performed to identify independent predictors.Receiver operating characteristic(ROC)curve analysis was used to evaluate the predictive performance of PSI and CURB-65 scores.Results Univariate analysis re-vealed significant differences between the two groups in the proportion of patients with ≥2 exacerbations in the past year,serum albumin(ALB),C-reactive protein(CRP),partial pressure of carbon dioxide(PaCO2),COPD Assessment Test(CAT)score,PSI score,and CURB-65 score(all P＜0.05).Logistic regression identified ≥2 exacerbations in the past year,ALB,CRP,CAT score,PSI score,and CURB-65 score as independent predictors of re-exacerbation within 30 days after remission(P＜0.05).ROC curve analysis showed that the area under the ROC curve(AUC)for PSI and CURB-65 scores in predicting re-exacerbation were 0.896(95％CI:0.845-0.947)and 0.808(95％CI:0.733-0.884),respectively.The Delong test indicated a statistically significant difference between the two AUCs(Z=2.107,P=0.035).Conclusion Short-term re-exacerbation in AECOPD patients after remission is significantly associated with PSI and CURB-65 scores.These scores can be used as valuable tools for risk stratification and early prediction of re-exacerbation.