DECAF Score

What is it?

A simple predictive tool (the Dyspnoea, Eosinopenia, Consolidation, Acidaemia and atrial Fibrillation Score), using indices routinely available at the time of hospital admission, can accurately predict inhospital mortality in patients hospitalised with acute exacerbations of chronic obstructive pulmonary disease.

Variable Points
Dyspnea limiting the patient to home (MRCD 5 and independent in bathing and/or dressing (eMRCD 5a) 1
Dyspnea limiting the patient to home (MRCD 5 and requires assistance with bathing and dressing (eMRCD 5b) 2
Eosinopenia (<0.05 x 109/L 1
Consolidation on CXR 1
Acidemia (pH <7.3) 1
Atrial fibrillation 1

Here’s a link to the MRC dyspnea scale. The “e” means that category 5 is “extended” into the two subgroups “5a” and “5b” above.

Using the model, patients can be categorized into three risk groups:

  • Low (0–1 point), in-hospital mortality 1.4%
  • Intermediate (2 points), in-hospital mortality 8.4%
  • High (3–6 points), in-hospital mortality 34.6%