Validation of CREWS and BAP-65 in predicting the need for mechanical ventilation of AECOPD patients

HUANG Wenting; CUI Miaoling; JIANG Yun; WANG Zixiu; LU Wangyang; KE Lan

doi:10.3969/j.issn.1002-266X.2017.07.006

Abstract：Objective To investigate the validation of chronic respiratory early warning score (CREWS) and BAP-65 in predicting the need for mechanical ventilation (MV) in acute exacerbations of chronic obstructive pulmonary disease (AECOPD) patients in normal ward.Methods A total of 211 patients with AECOPD in normal ward were selected.According to the need for MV they were divided into MV group (observation group) and non-MV group (control group).CREWS and BAP-65 were scored in 211 patients within 24 hours of admission.We built the ROC curve to analyze the performance of CREWS and BAP-65.Results The scores of CREWS in the observation group and control group were (5.91 ± 2.67) and (3.39 ± 1.74) points,and the differences were statistically significant (P ＜ 0.05).The grade of BAP-65 in observation group:there were 7 cases of grade Ⅰ,19 cases of grade Ⅱ,15 cases of gradeⅢ,4 cases of gradeⅣ and 0 of grade V,while they were 31,97,36,2 and 0 cases,respectively in the control group (P ＜ 0.05).The AUROC of CREWS and BAP-65 that predicted MV were 0.779 and 0.598,respectively,and the differeuces were statistically significant (P ＜ 0.05).AUROC of CREWS was significantly higher than that of BAP-65 in predicting the need for MV in AECOPD patients in normal ward (P ＜ 0.05).The cut-off points of CREWS were ＞ 5,the sensitivity was 51.11％,and the specificity was 86.75％.The cut-off points of BAP-65 were ＞ l grade,the sensitivity was 42.22％,and the specificity was 77.11％.Conclusion Both CREWS and BAP-65 can be used to predict the need for MV of AECOPD patients in normal ward,but the performance of CREWS is more accurate and suitable than that of BAP-65.