peering into the future guiding copd conversations · pdf filepulmonary rehabilitation and the...

Guiding COPD Conversations Peering into the FutureSWR Intensive Medicine RetreatFebruary 17, 2017

Theodore Moon, MD

Chronic Obstructive Pulmonary Disease

The Impact

Physician ability to predict COPD mortality stinks

J Gen Intern Med. 2009 Aug; 24(8): 923–928

68% of deceased COPD or HF patients had clinicians who provided a life expectancy estimate of >1 year, within six months prior to patient death.

Pulmonary rehabilitation and the BODE index in COPD

European Respiratory Journal 2005 26: 630-636

pulmonary rehabilitation participation improves BODE and is associated with better outcomes

What if my patient doesn’t get physically better with pulmonary rehab?

What happens to patients with COPD with long-term oxygen treatment who receive mechanical ventilation for COPD exacerbation? A 1-year retrospective follow-up study

Thorax. 2015 Mar; 70(3): 294–296.

Retrospective cohort study

Based on CMS data•4791 patients on long term oxygen

therapy that required intubation and mechanical ventilation for COPD exacerbationo Mortality, inpatient and 12 montho Readmissiono Disposition

26.8% of patients discharged to SNF in 30 days12.3% of patients discharged to SNF after 30 days

of the patients were dead at one year

68.5%

What is your patient’s healing narrative?