Pulmonary Patients

The new laboratory base method of estimating outcomes for patients with a severe pulmonary disorder that has no cure can help physicians better provide proper care, referrals, and services for patients at the end of life, according to a new study of more than 17,000 patients from Intermountain Healthcare.

Hospitalization rates for patients

The Laboratory base Inter mountain Validate Exacerbation (LIVE) score is a prediction model; so that predicts all-cause mortality, morbidity; also hospitalization rates for patients with chronic obstructive pulmonary disease (COPD); so a chronic, progressive lung disease that gradually makes it hard to breathe. COPD affects roughly 16 million Americans, or just under five percent of the U.S. population. It’s estimate that millions more have the disease, but are undiagnosed.

The LIVE score combines a patient’s simple laboratory values (levels of hemoglobin, albumin, creatinine, chloride, and potassium) to identify patients who are at high risk of death or further disease advancement; also who may most need referrals to palliative care and advance care planning resources.

In the study, Intermountain Healthcare researchers calculate the LIVE scores of 17,124 patients with COPD from the Kaiser Health System Northwest Region. They find that patients with high-risk LIVE scores had the highest one year mortality rates (39.4%); also the highest rate of palliative care referrals (41.7%). In comparison, patients with the lowest risk LIVE scores had 0.7% all cause one-year mortality and 0.7% palliative care referral rate.

Population health perspective

They find the LIVE score helps personalize therapy to patients beyond the COPD diagnosis alone and provides additional risk information to both patients and their doctors. From a population health perspective, the LIVE score allows for designing pathways of care that identify; also treat patients base on individual risk beyond a single diagnosis label alone. Results from the study will be present at the annual international conference of the American Thoracic Society, in Dallas on May 19.

Researchers say the findings can help physicians determine; which of their COPD patients are at highest risk, and who may benefit from palliative care and appropriate end-of-life services. Palliative care focuses on relief from the symptoms of a serious disease; so rather than on a cure, and is often provide in the final stages of a patient’s life.

“Our findings lend more insight into how they can use these laboratory base scores at the bedside to ensure that patients are receiving the most appropriate care,” she said. “This doesn’t mean everyone with high risk needs to be referr to palliative care; but it shows potential opportunities to improve care for patients in that highest risk group,” said Dr. Blagev.

Researchers note that the LIVE score model; which has already validate in more than 100,000 COPD patients at several diverse health systems; so these new study findings further demonstrate; so the effectiveness of using the model to enhance care and planning for patients.