What DECAF score is safe for early discharge?

DECAF 0-1 predicts <1% mortality; low-risk patients can be considered for early discharge or home oxygen pathway.

DECAF Score AECOPD Hospitalization Risk Calculator

Predict in-hospital mortality for acute COPD exacerbations using DECAF score: Dyspnea, Eosinopenia, Consolidation, Acidemia, Atrial Fibrillation.

eMRCD grade (dyspnea)

eMRCD 1–4 = 0 pts · eMRCD 5a = +1 pt · eMRCD 5b = +2 pts

Eosinophils (×10⁹/L)

Arterial pH

Criteria (each present adds 1 point)

0/ 6

Low Risk — in-hospital mortality ~1–4%

Recommended disposition

Low risk of in-hospital death — standard ward care with routine monitoring.

Clinical Guidance

The DECAF score predicts in-hospital mortality in acute exacerbation of COPD. It combines the extended Medical Research Council dyspnoea grade (eMRCD), eosinopenia (eosinophils < 0.05 ×10⁹/L), consolidation on chest X-ray, acidaemia (arterial pH < 7.30), and atrial fibrillation. A score of 0–1 identifies patients at low risk (~1–4% mortality) who may be managed on a standard ward; a score of 2 is intermediate risk (~5–10%); scores of 3–6 are high risk (>15–50%) and warrant escalation to HDU or ICU.

The score is a decision aid, not a substitute for clinical judgment. Always interpret it alongside the full clinical picture, arterial blood gas results, and local protocols.

How It Works

Predict in-hospital mortality for acute COPD exacerbations using DECAF score: Dyspnea, Eosinopenia, Consolidation, Acidemia, Atrial Fibrillation

Each component has a specific meaning:

DECAF score: Dyspnea — The decaf score: dyspnea recorded for the scenario being assessed.
Eosinopenia — The eosinopenia recorded for the scenario being assessed.
Consolidation — The consolidation recorded for the scenario being assessed.
Acidemia — The acidemia recorded for the scenario being assessed.
Atrial Fibrillation — The atrial fibrillation recorded for the scenario being assessed.

Note: Interpret the decaf score result against the thresholds and context described above.

How to Use

Enter the DECAF score: Dyspnea, Eosinopenia, Consolidation, Acidemia, Atrial Fibrillation for the scenario you are assessing. Predict in-hospital mortality for acute COPD exacerbations using DECAF score: Dyspnea, Eosinopenia, Consolidation, Acidemia, Atrial Fibrillation. Use the decaf score result to inform your calculation.

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