#ATS2018 — New Tool Can Determine Risk of Hospitalization for COPD Patients, Study Finds

A newly developed tool can predict patients with chronic obstructive pulmonary disease (COPD) who are at a high risk of hospitalization due to a disease flare-up, according to a study.

The new Laboratory-based Intermountain Validated Exacerbation, or LIVE, score identifies patients who may benefit from early intervention to avoid hospitalization by using routine laboratory tests to assess a patient’s risk of hospital admission in real time. It was developed and validated in more than 132,000 patient records at Intermountain Medical Center in Salt Lake City.

COPD exacerbations consist of an acute worsening of symptoms, such as shortness of breath, wheezing, and chest tightness, which typically last for several days and may lead to hospitalization.

Scientists found that most patients experiencing COPD exacerbations were in the two highest risk groups of the LIVE score. In contrast, fewer patients in the lowest risk group had flare-ups.

“We believe the ability to effectively identify these patients and intervene earlier in the course of a COPD exacerbation may help provide them with a higher quality of life, and potentially reduce medical costs associated with preventable hospital admissions,” Denitza Blagev, MD, the study’s principal investigator, said in a press release.

The LIVE risk score was validated in a retrospective study among 48,871 patients diagnosed with COPD at Intermountain Healthcare between 2009 and 2016, and then validated in 83,134 patient records from the Veterans Affairs National Health System.

Findings on the LIVE score model were recently presented at the American Thoracic Society (ATS) 2018 international conference in San Diego.

COPD treatment is aimed at easing symptoms and includes approaches such as inhalers, oxygen treatment, physical activity training, and pulmonary rehabilitation. However, the course and progression of the disease varies from patient to patient.

“Although we currently think about COPD as a single disease, the course and progression of the disease is variable among patients. It’s not only based on the severity of their COPD and lung function, but also on the number and variety of other medical problems a patient may have,” said Blagev, who is a pulmonary and critical care physician at Intermountain Medical Center and medical director for quality for Intermountain Healthcare.

Besides improving patient care by determining when earlier interventions may be useful, the LIVE score tool may also help educate patients and families on what to expect in the future after a COPD diagnosis.

Although further studies are required to assess the tool’s use as a population health strategy in COPD patients, Blagev is encouraged by the initial findings.

“Because the LIVE Score is laboratory based and reproducible, we are able to calculate the LIVE score electronically and identify high risk patients at the time of contact,” she said.

Blagev added that the tool can be used with previously collected data, even when patients are not in the hospital, enabling the development of interventions for patients at the highest risk.