Prognostic Utility of the CAUDA 70 score in Acute Exacerbations of COPD

Abstract

Background: Chronic obstructive pulmonary disease is a major cause of morbidity and hospitalization worldwide, and acute exacerbations further increase healthcare burden. Reliable prognostic tools are required to predict outcomes and optimize management. The CAUDA 70 score, based on simple clinical parameters, has been proposed as an accessible bedside predictor. This study aimed to evaluate its prognostic value in patients admitted with acute exacerbations of COPD.
Methods: A hospital-based, observational, cross-sectional study was conducted at Tribhuvan University Teaching Hospital, Nepal. Patients aged ?40 years with a confirmed diagnosis of COPD were enrolled. Clinical and demographic data were recorded, and patients were stratified by CAUDA 70 scores. Outcomes assessed included ventilatory support, intensive care admission, acute exacerbation and hospital length of stay.
Results: A total of 180 patients with acute exacerbations of COPD (AECOPD) were included in the study. The mean age of participants was 67.16 ± 13.38 years, with 45% males and 55% females. The mean CAUDA 70 score was 1.34 ± 0.475. Significant correlations were observed between the CAUDA 70 score and arterial pH (r = 0.399, p < 0.001), serum urea (r = 0.244, p = 0.001), and mMRC score (r = 0.176, p = 0.018). Higher CAUDA 70 scores were associated with increased need for non-invasive ventilation (NIV) (?² = 47.41, p < 0.001), ICU admission (?² = 59.4, p < 0.001), and mortality (?² = 7.3, p = 0.007). The CAUDA 70 score also predicted longer hospital stays (p < 0.001). Mortality occurred in 15% of the cohort.
Conclusions: The CAUDA 70 score effectively predicts the severity of outcomes in AECOPD patients, including NIV requirement, ICU admission, prolonged hospitalization, and mortality. Its simplicity and reliance on readily available clinical and biochemical parameters make it a valuable prognostic tool, particularly in resource-limited settings.
Keywords: Cauda 70; chronic obstructive pulmonary disease; prognosis.