Predicting an AECOPD from vital signs during daily life: insights from novel technology

Abstract

Many studies have suggested the use of telemonitoring in the management of COPD, but the use of telemonitoring to predict the onset of an AECOPD is still unclear. We aimed to determine whether respiratory rate (RR), heart rate (HR), skin temperature (ST) and physical activity (PA), measured continuously using novel wearable technology can predict the onset of an exacerbation post-AECOPD. Following hospitalisation for an AECOPD, participants were asked to wear an Equivital vest during waking hours for 42 days to measure RR, HR, ST and PA. An AECOPD was classified as either mild (worsening of symptoms via the EXACT-Pro), moderate (change in medication), or severe (hospitalisation). Three time points within the 42 days were compared; i) three days during stable symptoms; ii) three days prior to the exacerbation; iii) the day of exacerbation. 31 participants provided sufficient vital signs and symptom data, with 14 participants (45%) exacerbating during the 6 weeks post-discharge (7 mild, 2 moderate, 5 severe). Little change was seen for HR, ST and PA between time points (Fig 1). RR increased across time points (median[IQR], 19.6[5.7]; 21.5[7.1]; 22.9[7.3]; Fig 1), but there was notable variation for all measures across all time points. We were unable to predict an exacerbation using these data. RR was the most promising vital sign; however, the wide variation for all vital signs limits their predictive capabilities.