A pilot study of daily telemonitoring to predict acute exacerbation in chronic obstructive pulmonary disease.

Abstract

Exacerbations of COPD (ECOPD) are important events in the course of COPD and they accelerate the rate of decline of lung function, and exacerbations requiring hospitalization are associated with significant mortality. Therefore, developing approaches of prevention and early treatment of ECOPDs are of special clinical interests. One of such approaches is telecare, including home telemonitoring. Daily telemonitoring of HR, BP, SpO₂ and spirometry was performed. Variables were compared using the bootstrap-boosted inference tests: the paired t-test or Wilcoxon signed rank test, depending on data normality, and categorical variables were compared using exact McNemar's test. Nineteen patients were included to the study. We observed significant decrease in SpO₂ 7 days preceding ECOPD (P = 0.007; Pbootstrap-boosted = 0.005) and increase in number of events of day-to-day decrease in oxygen saturation >4% in the period of 7 days preceding ECOPD versus reference period (P = 0.02). Oxygen saturation telemonitoring would be successfully used in predicting ECOPD. Recording of day-to-day decrease in oxygen saturation >4% as alarming events would be effective approach which would be easily implemented in telemonitoring devices, however this outcome should be further validated in larger size samples.