Table 3 Potential indicators for do-not-hospitalize AECOPD patients or hospitalization in a general ward or in a respiratory or medical intensive care units (ICU)

Insufficient home support

X

Good response to initial medical management

X

Failed response to initial medical management

X

Fewer symptoms (dyspnea on effort, RR < 30 breaths/min, SatO₂ > 90%, no confusion, no drowsiness)

X

Severe symptoms (resting dyspnea, RR ≥ 30 breaths/min, SatO₂ ≤ 90%, confusion, drowsiness)

X

Very severe symptoms (dyspnea) that respond inadequately to initial emergency therapy

X

Presence of serious comorbidities (e.g. heart failure, newly occurring arrhythmias, etc.)

X

Onset of new physical signs (e.g. cyanosis, peripheral edema)

X

Acute respiratory failure (without use of accessory respiratory muscles and change in mental status)

X

Acute respiratory failure (with use of accessory respiratory muscles and change in mental status)

X

Persistent or worsening hypoxemia (PO₂ < 40 mmHg) and/or severe respiratory acidosis (pH < 7.25)

X

Need for IMV

X

Hemodynamic instability (need for vasopressors)

X