Rome Proposal (COPD Exacerbation Severity)
Grades a COPD exacerbation at the point of care (Rome proposal, Celli 2021).
Open the calculator → Runs in your browser. Data leaves only if you deliberately send a problem report from the interactive tool.
Example
- Dyspnea VAS
- 6
- Respiratory rate
- 26 /min
- Heart rate
- 100 /min
- Oxygen saturation
- 95 %
- C-reactive protein
- 5 mg/L
Result: Rome proposal: moderate COPD exacerbation - 3 of the five variables are above cutoff.
The tool opens with these values already filled in. Replace them with your own.
What the result means
- Cutoffs
- Dyspnea VAS 5 or more; respiratory rate 24 or more; heart rate 95 or more; saturation under 92% or a fall over 3%; CRP 10 mg/L or more.
- Mild
- Fewer than three of the five variables above cutoff. A single alarming number does not make an exacerbation moderate.
- Moderate
- At least three of the five above cutoff.
- Severe
- A separate gate on the arterial blood gas, needing BOTH hypercapnia over 45 mmHg AND pH under 7.35. Hypercapnia alone is not severe.
- Scope
- Grades an episode from measurements already taken. Decides nothing about steroids, antibiotics, ventilation or admission.
What you enter
- Dyspnea VAS (0-10)
- Respiratory rate
- Heart rate
- Oxygen saturation
- Fall in saturation
- C-reactive protein
- PaCO2
- Arterial pH
How this is calculated
Celli BR, Fabbri LM, Aaron SD, et al. An updated definition and severity classification of chronic obstructive pulmonary disease exacerbations: the Rome proposal. Am J Respir Crit Care Med. 2021;204(11):1251-1258. Read the source ↗
A reference and educational tool. Not medical, legal, or financial advice, and not a substitute for clinician judgment.