Innovative risk score tool effectively predicts future risk of hospitalization for COPD patients

May 21, 2018, Intermountain Medical Center
Researchers have developed a new tool that utilizes basic laboratory tests to effectively identify patients with chronic obstructive pulmonary disease who are at high risk of being hospitalized due to a flare up of the condition. Credit: Intermountain Medical Center

Researchers have developed a new tool that utilizes basic laboratory tests to effectively identify patients with chronic obstructive pulmonary disease who are at high risk of being hospitalized due to a flare up of the condition.

The new risk-score stratification tool, developed and validated in more than 132,000 patient records by Intermountain Healthcare researchers at Intermountain Medical Center in Salt Lake City, is unique in that it uses laboratory tests used in routine care to determine whether patients are at high or low risk of hospital admission in real time.

Researchers say the new Laboratory-based Intermountain Validated Exacerbation tool, known as the LIVE Score, may help clinicians better care for COPD patients by predicting high-risk patients who may benefit from early and specific interventions to avoid hospitalization.

COPD is the name for a group of diseases, primarily emphysema and chronic bronchitis, that are chronic inflammatory lung diseases that cause obstructed airflow from the lungs that affect more than 15 millions Americans, according to the Centers for Disease Control and Prevention.

Acute exacerbation of COPD is a sudden worsening of COPD symptoms (shortness of breath, quantity and color of phlegm) that typically lasts for several days, and in severe situations can lead to hospitalization. Symptoms can be exacerbated, or worsened, by airborne irritants like secondhand smoke, dust, pollen, fumes or air pollution. During a flare up, patients may end up in their doctor's office, the emergency department, or require hospitalization.

In the retrospective study, researchers found the majority of patients who experienced COPD exacerbations were in the LIVE risk-score model's two highest risk groups. Conversely, patients in the risk model's lowest risk group, fewer patients had exacerbations.

"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," said principal investigator Denitza Blagev, MD, a pulmonary and critical care physician at Intermountain Medical Center and medical director for quality for Intermountain Healthcare .

Results of the study of the LIVE Score model will be presented at the American Thoracic Society's annual international conference in San Diego on Monday, May 21, at 9:15 a.m, PDT.

The LIVE risk score was validated among 48,871 patients who received a COPD diagnosis at Intermountain Healthcare between 2009 and 2016, and later validated among 83,134 patient records from the Veterans Affairs National Health System. Researchers from the University of California, San Francisco, and the VA Medical Center in San Francisco participated in the study.

At first, COPD may cause no symptoms or only mild symptoms. As the disease gets worse, symptoms usually become more severe. They include: a cough that produces mucus, shortness of breath (specially with physical activity), wheezing, and chest tightness.

There is currently no cure for COPD, but treatments are available to manage the symptoms and include: medications (such as inhalers), pulmonary rehabilitation, physical activity training, and oxygen treatments.

"Although we currently think about COPD as a single disease, the course and progression of the disease is variable among patients," said Dr. Blagev. "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."

The new LIVE scoring tool allows for improved COPD patient care on a health system level by identifying when earlier interventions may prove useful, while educating patients and families on what the future may look like for an individual patient diagnosed with COPD.

Dr. Blagev said further study is needed to examine the utility of the LIVE Score as a population health strategy in COPD patients. But she is encouraged by 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 noted. "We can also identify patients based on data previously collected, even if they are not in the hospital currently, and can begin to develop interventions targeting these highest risk ."

Explore further: COPD action plan shortens duration of flare-ups and reduces hospital admissions

Related Stories

COPD action plan shortens duration of flare-ups and reduces hospital admissions

September 28, 2017
The University of Twente carried out the first study worldwide that shows patients with COPD (lung disease caused by smoking) and other illnesses (heart disease, diabetes, anxiety and depression) have better outcomes if they ...

COPD exacerbations in those with CVD may increase heart attack/stroke risk

May 21, 2017
After an acute exacerbation of chronic obstructive pulmonary disease, or COPD, people with a history of cardiovascular disease (CVD) or people at risk for CVD appear more likely to suffer a heart attack or stroke, according ...

Process used to select lung transplant patients may need to be changed: study

November 14, 2017
With a limited number of lungs available, deciding who gets a transplant can be a matter of life or death. New research from the University of Maryland School of Medicine (UMSOM) suggests that the system for choosing transplant ...

Physical activity found to decrease risk of dying in COPD

March 17, 2016
Any amount of moderate to vigorous physical activity can effectively reduce the risk of dying after hospitalisation for chronic obstructive pulmonary disease (COPD), according to a new study.

Exacerbations of COPD accelerate lung-function loss

May 17, 2016
Exacerbations of chronic obstructive pulmonary disease (COPD) accelerate the loss of lung function especially among patients with mild disease, according to researchers at National Jewish Health and other institutions. Barry ...

Early COPD diagnosis could save billions

May 17, 2017
If 600,000 Swedish patients with chronic obstructive pulmonary disease (COPD) had received their diagnoses two years earlier, it could have saved more than SEK 15 billion in direct healthcare costs during the first two years ...

Recommended for you

Breakthrough in designing a better Salmonella vaccine

September 24, 2018
UC Davis researchers announce in the Proceedings of the National Academy of Sciences this week a breakthrough in understanding which cells afford optimal protection against Salmonella infection—a critical step in developing ...

Antifungal agent found to be possible treatment for porphyria

September 24, 2018
A large team of researchers from Spain, France and the U.S. has found that a common antifungal agent might be useful as a treatment for a rare type of porphyria. In their paper published in the journal Science Translational ...

New findings on the muscle disease Laing early-onset distal myopathy

September 24, 2018
New avenues are now being opened toward treatment of Laing distal myopathy, a rare disorder that causes atrophy of the muscles in the feet, hands and elsewhere. In a study published in the journal PNAS, researchers have identified ...

Insulin shows great potential against chronic colitis

September 24, 2018
Diabetes is not the only disease on which insulin has an effect, it appears. In a new study using tests on mice, researchers from the University of Copenhagen, among others, have discovered a new method for treating chronic ...

A new approach to developing a vaccine against vivax malaria

September 21, 2018
A novel study reports an innovative approach for developing a vaccine against Plasmodium vivax, the most prevalent human malaria parasite outside sub-Saharan Africa. The study led by Hernando A. del Portillo and Carmen Fernandez-Becerra, ...

Pre-clinical success for a universal flu vaccine offers hope for third generation approach

September 21, 2018
Researchers from the University of Oxford's Department of Zoology have demonstrated pre-clinical success for a universal flu vaccine in a new paper published in Nature Communications.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.