Table 2.
A patient hospitalized for AECOPD is eligible for proactive palliative care when meeting ≥2 criteria of the following set of indicators: | |
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1. | Hypoxaemia and/or hypercapnia at discharge |
2. | Treatment of the exacerbation with non-invasive ventilation (NIV) |
3. | Patient needs professional home care service for personal care after discharge |
4. | Negative answer to the surprise question: ‘Would I (as lung specialist) be surprised if this patient would have a subsequent readmission for AECOPD within 8 weeks and/or would die in the next year? |
5. | The diagnosis of a severe comorbidity such as: Non-curable malignancy or Cor pulmonale (proven or non proven) or Proven Chronic Heart Failure (CHF) or Diabetes mellitus with neuropathy or Renal failure, clearance < 40 (GFR: in ml/min) |
6. | CCQ total, day version ≥ 3 |
7. | MRC dyspnoea = 5 |
8. | FEV1 (measured before AECOPD) <30% of predicted |
9. | BMI < 21 or unplanned weight loss (>10% weight loss in last 6 months or > 5% in last month) |
10. | Previous hospital admissions for AECOPD (last 2 years > 2 and/or last year > 1) |
11. | Age > 70 years |
AECOPD: acute exacerbation chronic obstructive pulmonary disease; GFR = glomerular filtration rate; CCQ: clinical COPD questionnaire; MRC dyspnoea:medical research council dyspnoea questionnaire; FEV1 = forced expiratory volume in 1 second; BMI: body mass index.