COPD Hospital Readmission, Mortality Risk Predicted by 3-Variable Score

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The MEP score predicted risk for rehospitalization and mortality in patients with COPD.
The MEP score predicted risk for rehospitalization and mortality in patients with COPD.
The following article is part of conference coverage from the CHEST 2017 in Toronto, Canada. Visit Pulmonology Advisor's  conference page for more conference news.

TORONTO — A high MEP score, which is composed of the MRC (Medical Research Council) dyspnea score, prior hospitalization for chronic obstructive pulmonary disease (COPD) Exacerbations, and chronic Prednisone use, predicts risk for mortality and rehospitalization in patients admitted for COPD, according to a study presented at CHEST 2017, held October 28 to November 1 in Toronto, Ontario, Canada.

“In hospitalized COPD patients, risk stratification for subsequent readmission or mortality might prove useful in focusing resources,” wrote the investigators. “In a recent pilot study we found that 3 variables...predicted risk of 30-month readmission.”

Investigators evaluated the prognostic utility of the MEP score for predicting risk for rehospitalization and subsequent mortality at 180 days in patients hospitalized for COPD exacerbations (n=50). The MEP score consisted of 3 variables: MRC dyspnea score (MRC 0-3, score =0; MRC 4, score =1), COPD exacerbations 1 year prior to index hospitalization (1 or more, score =1), and chronic prednisone use at hospital admission (yes, score =1).

Approximately 60% of patients included in this study had been admitted to the hospital for COPD exacerbations prior to the index hospitalization, fulfilling one of the variables in the MEP score. In addition, 26% of patients were taking prednisone at hospital admission.

According to the investigators, a higher MEP score in admitted patients predicted future rehospitalization or mortality events up to 180 days following the index hospitalization. The odds ratios for either a rehospitalization or mortality event per 1 unit rise in MEP were 2.3, 2.2, 2.8, and 2.1 at 30 days, 60 days, 90 days, and 180 days, respectively.

“The MEP score offers a new tool for identifying [those with] COPD who are at risk for readmission, for whom additional measures can be instituted to prevent readmission,” concluded the investigators.


Yap V, Datta D, Wilcox D, Williams L, ZuWallack R. The MEP Score: a three-variable clinical scoring system for predicting all-cause COPD readmissions or deaths. Presented at: CHEST 2017; October 28-November 1, 2017; Toronto, Ontario, Canada. Abstract 2742338.