Table 3 COPD: criteria for suitability for Hospital-at-Home care
Patients with COPD suitable for Hospital-at-Home carePatients with COPD in whom hospitalisation is indicated
Mild exacerbation of COPD. Increased cough, sputum and mild increase in breathlessness. Patient is able to eat and sleep despite increase in symptomsIncrease in symptoms despite treatment. Patient unable to eat or sleep due to respiratory symptoms. New cyanosis or signs of cor pulmonale developing
Mental status unchanged; patient fully alertChange in mental status
Respiratory rate <24/minRespiratory rate ⩾24/min
Patients do not have arrhythmia, clinical signs of pneumonia or signs of heart failureSigns of these are developing or other systemic disease such as hypotension reduced urine output
Signs suggestive of exacerbation of COPD in patients known to have COPDUncertainty of the diagnosis (eg, haemoptysis, weight loss, clinical signs of segmental collapse, pleural effusion or pneumothorax, symptoms suggestive of ischaemic heart disease or heart failure)
Exacerbations with preserved oxygen saturation (>92%)Exacerbations requiring oxygen therapy; oxygen saturation ⩽92% in a patient not known to need long-term oxygen therapy
Patient requiring oral antibioticsPatients not responding to oral antibiotics who might need intravenous antibiotics
Patient supported by family memberLack of carer support (eg, hospitalisation of spouse or carers during COPD exacerbation)
Mobility regarded to be adequateImpairment or increased impairment of mobility