The BAP-65 score calculator helps estimate the risk of in-hospital mortality for patients experiencing an acute exacerbation of COPD by evaluating four key clinical parameters: blood urea nitrogen (BUN) levels, mental status, pulse rate, and age.

Inputs you need to consider:
- BUN level, assessed as either: 
  - Yes: BUN ≥ 25 mg/dL (8.9 mmol/L)
  - No
- Mental status, categorized as:
  - Yes: Altered 
  - No
- Pulse rate, indicated as either:
  - Yes: Pulse ≥ 109 beats per minute
  - No
- Age, grouped as:
  - 41-64 years
  - ≥ 65 years

The calculation involves each parameter contributing to an overall risk class from I to V, with increasing class numbers indicating higher risk of mortality.

Steps and interpretation possibilities:
- Class I: If BUN is normal, mental status is normal, pulse is normal, and age is between 41-64 years, the risk of in-hospital mortality is 0.5%.
- Class II: If BUN is normal, mental status is normal, pulse is normal, and age is ≥ 65 years, the risk is 1.4%.
- Class III: For patients of any age with one of the following—high BUN, altered mental status, or high pulse—the risk rises to 3.7%.
- Class IV: For patients of any age displaying two of the following—high BUN, altered mental status, or high pulse—the risk increases significantly to 12.7%.
- Class V: For patients of any age with high BUN, altered mental status, and high pulse, the risk peaks at 26.2%.

This structured approach enables healthcare professionals to assess and stratify the mortality risk associated with acute exacerbation of COPD effectively, guiding treatment decisions and patient management strategies.

The BAP-65 score is a clinical calculator used for patients with acute exacerbations of Chronic Obstructive Pulmonary Disease (COPD). The name BAP-65 stands for Blood Urea Nitrogen (BUN), Altered Mental Status, Pulse, and age 65. This scoring system is used to predict in-hospital mortality and the need for mechanical ventilation in patients with COPD exacerbations. 

The BAP-65 score is calculated based on four criteria: BUN > 25 mg/dL, altered mental status, pulse ≥ 109 beats per minute, and age ≥ 65 years. Each criterion is assigned one point, and the total score ranges from 0 to 4. Higher scores indicate a higher risk of in-hospital mortality and the need for mechanical ventilation.

The BAP-65 score is applicable to patients with acute exacerbations of COPD. It is not suitable for use in patients without COPD, or in those with other primary causes of respiratory failure. It should also not be used in isolation to make clinical decisions, but rather as a tool to aid in risk stratification and decision-making.

BAP-65 score for acute exacerbation of COPD