respiratory

DECAF Score for Acute Exacerbation of COPD

Dyspnoea, Eosinopenia, Consolidation, Acidaemia, and Atrial Fibrillation (DECAF) score predicts in-hospital mortality in acute exacerbations of COPD.

Used in: COPD

Score interpretation

Low Risk 0–1

DECAF 0–1 — in-hospital mortality 1.0% (1.4% in the derivation study).

→ Consider suitability for hospital at home or early supported discharge.

Intermediate Risk 2

DECAF 2 — in-hospital mortality 5.4% (8.4% in the derivation study).

→ Standard inpatient management; use clinical judgement on place of care.

High Risk 3–6

DECAF 3–6 — in-hospital mortality 21.4% (34.7% in the derivation study).

→ Escalation planning: HDU/ICU review, NIV if hypercapnic acidosis, and discussion of ceilings of care or early palliation.

Interpretation bands for the DECAF Score. Apply clinical judgement and local guidance.

Steer J, Gibson J, Bourke SC. The DECAF Score: predicting hospital mortality in exacerbations of chronic obstructive pulmonary disease. Thorax. 2012;67(11):970–976.
Echevarria C, Steer J, Heslop-Marshall K, et al. Validation of the DECAF score to predict hospital mortality in acute exacerbations of COPD. Thorax. 2016;71(2):133–140.

Curated clinical cross-links plus same-class fallbacks.

Calculators

Drugs

Pathways

Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.