05.02 - Monitoring airway disease 37471 Preventing hospital readmissions of COPD patients : alerting rules on vital signs for remote patient monitoring COPD - exacerbations, COPD - management, Acute respiratory failure Y. Le Guillou1, F. Tilquin1, S. Le Liepvre1, G. Brinchault2, T. Guy3, F. Thépault4 1Biosency - Cesson-Sévigné (France), 2CHU Rennes - Rennes (France), 3CHBA Vannes - Vannes (France), 4CH Saint Malo - Saint-Malo (France) Introduction After hospital discharge following an acute exacerbation of COPD (AECOPD), remote patient monitoring (RPM) can prevent readmissions [1] by alerting healthcare professionals when vital signs exceed some limits. Objectives Compare the performance of different vital signs alert configurations in early detection of readmission. Methods Breath rate (BR), heart rate (HR) and SpO2 of COPD patients were monitored by Bora Care RPM solution during hospitalization for AECOPD and 30 days after discharge. Results 21 COPD patients (GOLD grade: 9.5% I, 19% II, 33% III, 24% IV; mean age 67 years) were monitored for an average session duration of 37 days (SD 11 days), 5 patients (23.8%) were readmitted. The area under the curve (AUC) of the Receiver Operating Characteristic curve (ROC) was computed to rank the performance of several alert rules on 1) fixed thresholds and 2) variable thresholds based on deviation of the last 48-hour median value from a 15-day baseline. The variable threshold applied simultaneously to SpO2, HR and BR is the best performing alert (AUC=0.84), followed by the fixed threshold applied to SpO2, HR and BR (0.82) and the variable threshold applied to HR only (0.76).

Fixed thresholds on Sp02 and HR and BR (AUC = 0.82 Variab e threshold on 20% False Positive Rate Figure: ROC cun/e for the early detection of COPD patient at risk of readmission Early detection of a patient's risk of readmission is optimized when SpO2, HR and BR all exceed variable thresholds derived from the patient's 15-day baseline.