MDCalc

BAP-65 Score for Acute Exacerbation of COPD

Predicts mortality in acute COPD exacerbation.

Use in patients >40 years of age presenting to the emergency department with acute COPD exacerbation. Use the worst variables on the day of admission.

BUN ≥25 mg/dL (8.9 mmol/L)

Altered mental status

Initial Glasgow Coma Scale <14, or disorientation, stupor, or coma as determined by physician

Pulse ≥109 beats/min

Age, years

BAP-65 is not validated in patients ≤40 years old (see When to Use).

Result:

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Advice
  • Consider early non-invasive ventilation and/or ICU care in patients with higher in-hospital mortality.
  • May predict the need for mechanical ventilation within 48 hours, and these patients should be considered for higher level of care to provide non-invasive and/or invasive ventilation.
  • There may be a role for early discharge or observation in lower BAP-65 classes.
Management

Was not studied to dictate management or treatment options. The score should not replace clinical judgment regarding workup, diagnosis, or treatment.

Critical Actions
  • Should only be used in patients presenting to the ED with a primary diagnosis of an acute COPD exacerbation, not in the outpatient setting or in patients whose COPD is stable.
  • BAP-65 class V have the highest risk of in-hospital mortality and need for mechanical ventilation, and these patients should be closely monitored.
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