Table 7 Criteria for appropriate hospital admission for COPD exacerbations

Inadequate or failed response to outpatient treatment

Presence of high risk comorbidity (pneumonia, arrhythmia, congestive heart failure, diabetes, liver or renal failure) or very elderly patients

Past history of frequent exacerbations

Significant increase in dyspnea and/or onset of new signs (cyanosis, peripheral edema, arrythmias)

Significant worsening in hypoxemia

Worsening in hypercapnia/respiratory acidosis (not detectable at the patient bedside)

Mental status alterations

Lack of or unreliable family assistance

Diagnostic uncertainty