Validation of the Rome proposal for severity of acute exacerbation of chronic obstructive pulmonary disease

BACKGROUND: The Rome proposal provides an objective assessment tool for severity of acute exacerbation of chronic obstructive pulmonary disease (AE-COPD) but requires validation. OBJECTIVES: We aimed to evaluate the predictive performance of the Rome proposal in patients with AE-COPD. DESIGN: This observational study assessed the patients who visited the emergency room (ER) or were hospitalized due to AE-COPD between January 2010 and December 2020. METHODS: We compared the performance of the Rome Proposal with that of the DECAF score or GesEPOC 2021 criteria in predicting intensive care unit (ICU) admission, need for non-invasive ventilation (NIV) or invasive mechanical ventilation (IMV), and in-hospital mortality. There was no significant difference in predicting the in-hospital mortality between the Rome proposal and DECAF score or GesEPOC 2021 criteria. CONCLUSION: External validation of the Rome Proposal in Korean patients demonstrated excellent performance for ICU admission and need for NIV or IMV and an acceptable performance for in-hospital mortality.