An American team has just developed new risk scores for patients with chronic obstructive pulmonary disease (COPD). Their objective: to provide patients at high pulmonary risk at the end of life with better care.
Will it soon be possible to predict mortality, morbidity and hospitalization rates for patients with severe lung disorders?
In any case, this is the wish of a team of researchers from Intermountain Healthcare, a non-profit health system located in Salt Lake City, in the United States. The latter presented their innovation at the annual conference of the American Thoracic Society which took place in Dallas on May 19: a new method for estimating the risks for patients with chronic obstructive pulmonary disease (COPD).
A score that takes into account other pathologies
Affecting an average of 4% of French people and responsible for 16,000 deaths each year, COPD is an inflammatory disease characterized by obstruction of the bronchi, cough and chronic expectoration. This disease begins insidiously and most patients do not notice symptoms until it is well established. In most cases, smoking is the cause.
To better detect this disease and provide patients with appropriate care, researchers conducted a study with 17,124 patients with COPD. The latter allowed them to develop a new method for estimating the results of patients with a severe incurable lung disorder, which they called the LIVE score.
“We have found that the LIVE score helps to personalize treatment for patients beyond just diagnosing COPD and provides additional risk information to patients and their physicians. From a population health perspective, the LIVE score enables the design of care pathways that identify and treat patients based on individual risk beyond a single diagnostic label,” says Dr. Denitza Blagev, lead author of the study and medical specialist pulmonary and intensive care at the Intermountain Medical Center.
The LIVE score is based entirely on blood tests and assesses patients’ rates of other diseases and not just lung function. Although diseases such as heart and kidney disease contribute to the risk of death, hospitalization and symptoms in patients with COPD, until now there has been no systematic way to incorporate these diseases into the determination of risk. global for patients at high pulmonary risk.
Towards better care at the end of life
According to the researchers, these new risk scores will be valuable for doctors as they will help them determine which of their COPD patients are most at risk. The latter will be able to benefit from palliative care and the best end-of-life treatments.
“By exploring the association between palliative care referrals and LIVE score risk, this study is a step forward in understanding how the LIVE score can be used to target appropriate care to patients.” Dr Blagev. “Our results give us a better idea of how we can use these laboratory results at the bedside of patients to ensure that they receive the most appropriate care,” continues the researcher. But, she recalls, “this does not mean that everyone at high risk should be referred for palliative care. It just shows opportunities to improve care for patients in this high-risk group.”
This LIVE scoring model has already been validated in over 100,000 patients with COPD across multiple US healthcare systems. The results of these new studies may further demonstrate the effectiveness of using the model to improve patient care and planning, the researchers say.
.
