Calculators · Respiratory Medicine · Score

DECAF score for COPD exacerbation

Also called DECAF, AECOPD mortality score

In-hospital mortality risk in patients admitted with an acute exacerbation of COPD.

Stable-state dyspnoea (extended MRC, best day in past 3 months)

Fill 1 more field to see the result.

Formula and scoring

eMRCD 5a 1, 5b 2; eosinopenia 1; consolidation 1; acidaemia (pH <7.30) 1; atrial fibrillation 1. Bands 0–1, 2, 3–6.

Exam and ward pearls

  • Dyspnoea is scored on the patient's usual best day, not on admission.
  • A patient who can walk 30–40 m and leave the house unaided is eMRCD 4, not 5.

When not to rely on it

  • Derived and validated in UK hospitals; uses in-hospital mortality as outcome.

Source

  1. Steer J, Gibson J, Bourke SC. The DECAF Score: predicting hospital mortality in exacerbations of chronic obstructive pulmonary disease. Thorax. 2012;67(11):970-6. doi:10.1136/thoraxjnl-2012-202103 · PMID 22895999
  2. 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):133-40. doi:10.1136/thoraxjnl-2015-207775 · PMID 26769015

Formula and cut-offs checked against these sources on 8 Nov 2026. Educational tool for clinicians; it does not replace clinical judgement.

More Respiratory Medicine calculators