Preventing Repeat Hospitalisations in Patients With Chronic Obstructive Pulmonary Disease (COPD)
Preventing Repeat Hospitalisations in Patients With Chronic Obstructive Pulmonary Disease (COPD)
The purpose of this study is to determine whether the investigators can predict which
 patients are at risk of a re-exacerbation of COPD within 30 and 90 days using changes in lung
 capacity during the initial exacerbation.
Patients admitted to hospital with an acute exacerbation of COPD will be approached to
 participate in the study.

 The investigators will analyse changes in lung capacity (through measurement of spirometry
 and inspiratory capacity) and physical activity level over the first three days of admission,
 at discharge and at a day 30 follow-up visit. The investigators will record quality of life
 and symptom scores at these time points and again at a day 90 telephone visit. Data relating
 to the patients overall health status -disease severity, co-morbidity, cognition,
 psychological status, home environment and adherence to inhaled medication will be collected.
 The investigators will look for any relationship between these changes and a further
 exacerbations within 30 and 90 days.

 The central hypothesis of this proposal is that the clinical course following an exacerbation
 of COPD may be monitored through measurement of inspiratory capacity(IC), a marker of lung
 hyperinflation. Resolution of an exacerbation is related to an increase in inspiratory
 capacity above a threshold level of improvement, after which the risk of re-exacerbation
 within the subsequent 30 and 90 days is low. The investigators will assess the accuracy of IC
 as a predictor of exacerbation and the feasibility of measuring IC during the early stages of
 a COPD exacerbation.
Inclusion Criteria:

 -  Within 72 hours of admission with an Acute Exacerbation of COPD (AE COPD) defined as
 "an acute change in a patient's baseline dyspnoea, cough and/or sputum beyond
 day-to-day variability sufficient to warrant a change in therapy" as per ATS/ERS
 consensus guidelines[ ] where "a change in therapy" includes the following:
 Prescription of antibiotics and / or systemic steroids

 -  Diagnosis of COPD based on GOLD criteria

 -  Able to give informed consent

 -  Willing to participate in the study

 Exclusion Criteria:

 -  Admission reason other than AE COPD or breathlessness primarily caused by another
 pathology

 -  Already enrolled in the study

 -  Receiving palliative care

 -  Severe cognitive impairment or psychological disorder that results in inability to
 give informed consent or complete investigations required for the study

 -  Physical impairment resulting in inability to complete physiological tests