Introduction and objectives Chronic Obstructive Pulmonary Disease (COPD) is the second most common cause of emergency admission to hospital in the UK. Following an exacerbation there is a high risk of recurrence. Early identification and prompt treatment of exacerbations have been shown to reduce risk of hospital admission.1 Respiratory rate changes during an episode of exacerbation and may serve as the warning signal of developing exacerbation. We aimed to determine whether a non-contact bedside sensor (SleepMinder TM) recording Nocturnal Respiratory Rate (NRR) could detect exacerbations in patients with COPD following hospital discharge.
Methods Patients were enrolled following a hospital admission for an exacerbation of there underlying COPD. They were followed prospectively for 12 weeks and monitored by SleepMinder TM (Resmed) technology recording NRR. Demographics and clinical details were extracted from medical records. A research nurse contacted each participant weekly and recorded CAT scores and any healthcare contacts.
Results 15 patients completed the study period and recorded >75% of study data. Of these 8 patients had further exacerbations. Median time post discharge for an exacerbation was 56.5 days (IQR 41–67). There were no differences in baseline demographics between those who had an exacerbation and those that did not however there was a trend towards increased BMI, baseline CAT score and length of stay. Of the 8 patients who had an exacerbation a clear signal in NRR could be identified, by visual inspection, in 5 (62.5%) around the time of recorded health care contact. The average time from a signal to health care contact was 6.6 days indicating a window of opportunity for intervention. The was no significant trend between change of CAT score and change of NRR indicating patients may be unaware of impending exacerbation (p value 0.243).
Conclusions SleepMinder TM technology assessing nocturnal respiratory rate may have use in a real time clinician led connected health setting to trigger early intervention and prevent readmission following discharge.
Reference 1 Wilkinson TM, Donaldson GC, Hurst JR, et al. Early therapy improves outcomes of exacerbations of chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 2004;169:1298–303
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