Introduction: Chronic Obstructive Pulmonary Disease (COPD) remains the third leading cause of death globally, with a particularly high burden in Low and Middle-Income Countries (LMIC). Accurate risk stratification during Acute Exacerbation of Chronic Obstructive Pulmonary Disease (AECOPD) is crucial for optimising treatment and resource allocation. The modified DECAF score can be used as a simple bedside tool designed to predict in-hospital mortality and guide clinical decision making. Aim: The