ObjectiveTo develop a risk prediction scale for 6-month mortality in elderly patients with advanced chronic obstructive pulmonary disease (COPD), and provide a theoretical basis for creating tools to predict survival in this patient population. Methods A literature review was conducted to identify and extract risk factors associated with 6-month mortality in elderly patients with advanced COPD, forming the initial item pool for the scale. A Delphi method was employed, involving two rounds of correspondence with 17 multidisciplinary experts through a designed questionnaire. Items were comprehensively screened based on the arithmetic mean of item importance, coefficient of variation, and full score frequency to determine the final scale. ResultsThe effective response rates for the two rounds of expert correspondence were 94.12% and 100.00%, respectively. The expert authority coefficients were both ≥0.90 (0.93 and 0.90, respectively). The Kendall's coefficients of concordance were 0.28 and 0.26 (both P<0.05), indicating good coordination and authority among the experts and reliable results from the correspondence. The final constructed risk prediction scale for short-term mortality in elderly patients with advanced COPD includes 10 primary items and 55 secondary items. The 10 primary items are as follows: demographic characteristics, prognostic prediction, disease course, complications, comorbidity status, geriatric syndromes, signs/symptoms, COPD symptom scores, examination/laboratory indicators, and COPD treatment. ConclusionsThe Delphi-based risk prediction scale for 6-month mortality in elderly patients with advanced COPD is reliable and objective, and is expected to be a valuable tool to predict survival in this patient population.
