Predicting and Preventing COPD Readmissions
Read The Revolving Door Part 1 to catch-up!
In conjunction with proven treatment regimens during the acute care stay, some way to assess the patient’s “likelihood to readmit” must be quantified and linked to effective clinical interventions to be applied post discharge. Several assessment methods already exist:
The BODE Scoring system which measures Body Mass Index, obstruction of airflow, Dispnoea, and exercise tolerance, has recently shown promise as a predictor of admission in various studies.
GOLD Categorizations based on FEV1 have long been a means of assessing severity of disease state.
The COPD Assessment Test (CAT) is a new questionnaire for people with COPD. It’s designed to measure the impact of COPD on a person’s life, and how this changes over time.
I believe the challenge before us does not lie in any one particular assessment or test, but perhaps rather a composite, artful approach with a view to the development of a scoring algorithm that can be predictive of the “likelihood to readmit” or rather of AECOPD leading to readmission. Clinical interventions can then be enacted along the continuum of care post discharge to mitigate that likelihood. This is not a novel idea, much research has been and is being conducted along these and similar lines because everyone knows the best way to keep the door from revolving is to not open it in the first place.