ArticleCMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne2018
Clinical validation of a risk scale for serious outcomes among patients with chronic obstructive pulmonary disease managed in the emergency department.
Article in CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
17 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Chronic Obstructive Pulmonary Disease and the Management of Cardiopulmonary Risk in the UK: A Systematic Literature Review and Modified Delphi Study.International journal of chronic obstructive pulmonary disease · 2025Pooled it
- Assessment tools addressing avoidable care transitions in older adults: a systematic literature review.European geriatric medicine · 2024Pooled it
- Terms and Definitions Used to Describe Recurrence, Treatment Failure and Recovery of Acute Exacerbations of COPD: A Systematic Review of Observational Studies.International journal of chronic obstructive pulmonary diseasePooled it
- Implementation of 2023 Canadian Thoracic Society Guidelines for Single-Inhaler Triple Therapy Could Reduce Exacerbation and Mortality Rates in COPD: PROMETHEUS Canada.Chronic obstructive pulmonary diseases (Miami, Fla.) · 2026Article
- Novel Biomarkers for Prognostic Assessment of Patients with Acute Exacerbation of COPD in the Emergency Department-Tools to Enhance the Quality of Care in Critical Patient Management.Diagnostics (Basel, Switzerland) · 2026Article
- Article
- Prognostic Accuracy of DECAF and Ottawa COPD Risk Scores in Patients Presenting to the Emergency Department With COPD Exacerbation.Journal of acute medicine · 2025Article
- Validation and Comparison of BAP-65, DECAF, NEWS, and a Novel Combined Score for Predicting in-Hospital Mortality in Patients with Acute Exacerbation of COPD.International journal of chronic obstructive pulmonary disease · 2025Article
- Evaluation of the quality of emergency department management for patients with chronic obstructive pulmonary disease.Clinical and experimental emergency medicine · 2024Article
- The HEARTRISK6 Scale: Predicting Short-Term Serious Outcomes in Emergency Department Acute Heart Failure Patients.JACC. Advances · 2024Article
- The adjusted impact of different severities of acute exacerbations and medications on the risk of developing dementia in COPD patients.BMC pulmonary medicine · 2023Article
- Comparison of two scores for short-term outcomes in patients with COPD exacerbation in the emergency department: the Ottawa COPD Risk Scale and the DECAF score.ERJ open research · 2023Article
- Ottawa Risk Scale in Predicting the Outcome of Chorionic Obstructive Pulmonary Disease Exacerbation in Emergency Department; a Diagnostic Accuracy Study.Archives of academic emergency medicine · 2023Article
- Most important risk factor missing from COPD score.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2019Article
- An author responds to "Most important risk factor missing from COPD score".CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2019Article
- To keep patients with COPD out of hospital, look beyond the lungs.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2018Article
- 2021 Guideline for the Management of COPD Exacerbations: Emergency Medicine Association of Turkey (EMAT) / Turkish Thoracic Society (TTS) Clinical Practice Guideline Task Force.Turkish journal of emergency medicineArticle
Corrections and comments
- Commented on by
- Commented on by
- Commented on by
Authors and funding
12 authors.
Funding
Abstract
backgroundThe Ottawa chronic obstructive pulmonary disease (COPD) Risk Scale (OCRS), which consists of 10 criteria, was previously derived to identify patients in the emergency department with COPD who were at high risk for short-term serious outcomes. We sought to validate, prospectively and explicitly, the OCRS when applied by physicians in the emergency department.
methodsWe conducted this prospective cohort study involving patients in the emergency departments at 6 tertiary care hospitals and enrolled adults with acute exacerbation of COPD from May 2011 to December 2013. Physicians evaluated patients for the OCRS criteria, which were recorded on a data form along with the total risk score. We followed patients for 30 days and the primary outcome, short-term serious outcomes, was defined as any of death, admission to monitored unit, intubation, noninvasive ventilation, myocardial infarction (MI) or relapse with hospital admission.
resultsWe enrolled 1415 patients with a mean age of 70.6 (SD 10.6) years and 50.2% were female. Short-term serious outcomes occurred in 135 (9.5%) cases. Incidence of short-term serious outcomes ranged from 4.6% for a total score of 0 to 100% for a score of 10. Compared with current practice, an OCRS score threshold of greater than 1 would increase sensitivity for short-term serious outcomes from 51.9% to 79.3% and increase admissions from 45.0% to 56.6%. A threshold of greater than 2 would improve sensitivity to 71.9% with 47.9% of patients being admitted.
interpretationIn this clinical validation of a risk-stratification tool for COPD in the emergency department, we found that OCRS showed better sensitivity for short-term serious outcomes compared with current practice. This risk scale can now be used to help emergency department disposition decisions for patients with COPD, which should lead to a decrease in unnecessary admissions and in unsafe discharges.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.