Decision Rule - Ottawa COPD Score

Ottawa COPD Score

History

-Coronary bypass graft . . . . . . . . . . . . . . . . . . . . . . . . . .  [No (0 points)/Yes (+1 point)]

-Intervention for peripheral vascular disease  . . . . . . .  [No (0 points)/Yes (+1 point)]

-Any history of intubation for respiratory distress  . . .  [No (0 points)/Yes (+2 points)]

Examination

-Heart rate ≥110 beats/minute on arrival  . . . . . . . . . . .  [No (0 points)/Yes (+2 points)]

-To ill to do walk test after treatment in ED   . . . . . . . .  [No (0 points)/Yes (+2 points)]

(Saturation <90% or HR ≥120/min after 3 minute walk test)

Investigations

-Acute ischemic changes on EKG . . . . . . . . . . . . . . . . . .   [No (0 points)/Yes (+2 points)]

-Pulmonary congestion on chest x-ray  . . . . . . . . . . . . .  [No (0 points)/Yes (+1 point)]

-Hemoglobin <10 g/dL (100 g/L)  . . . . . . . . . . . . . . . . . .  [No (0 points)/Yes (+3 points)]

-BUN ≥34 mg/dL (Urea ≥12 mmol/L) . . . . . . . . . . . . . . .  [No (0 points)/Yes (+1 point)]

-Serum ≥CO₂ 35 mEq/L (35 mmol/L)  . . . . . . . . . . . . . . .  [No (0 points)/Yes (+1 point)]

TOTAL Score = [## points]

[Score 0] Patient deemed to be low risk for adverse events in the next 30 days based on the Ottawa COPD Risk scale consistent with a 2.2% risk.

[Score 1-2] Patient deemed to be medium risk for adverse events in the next 30 days based on the Ottawa COPD Risk scale consistent with a 4.0-7.2% risk.  We discussed this risk with the patient after noting significant improvement in symptoms prior to discharge.  Admission was considered and discussed with the patient, who preferred discharge home with close follow up.  Patient noted to have access to close follow up care, and demonstrated understanding of risk, return precautions, and follow up care.

[Score 3-7] Patient deemed to be high risk for adverse events in the next 30 days based on the Ottawa COPD Risk scale consistent with a [12.5/20.9/32.9/47.5/62.6]% risk.  We discussed this risk with the patient and recommended admission for further treatment.