Table 1 Set of indicators for proactive palliative care
A patient hospitalized for AECOPD is eligible for proactive palliative care when meeting two or more criteria of the following set of indicators: | |
|---|---|
1. | Hypoxaemia 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: |
a. Non-curable malignity or | |
b. Cor pulmonale (proven or non proven) or | |
c. Proven Chronic Heart Failure (CHF) or | |
d. Diabetes mellitus with neuropathy or | |
e. Renal failure, clearance < 40 (GFR: in ml/min) | |
6. | CCQ total, day version ≥ 3 |
7. | MRC dyspnea = 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 |