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A2170 - COPD Rehabilitation Program
Author Block: S. Patel1, K. Gafoor1, H. M. Belete1, M. Oron1, V. Shah1, E. L. Altschul1, Upper East Side Rehabilitation and Nursing Center, J. Homan2, B. A. Mina1; 1Medicine, Lenox Hill Hospital - Northwell Health, New York, NY, United States, 2Medicine, Lenox Hill Hospital - Northwell Health, NY, NY, United States.
Introduction: Pulmonary rehabilitation implemented within 3 weeks after discharge following an acute exacerbation of chronic obstructive pulmonary disease (AECOPD) has been shown to reduce hospital admissions and improves quality of life, while pulmonary rehabilitation implemented within 8 weeks after discharge increases exercise capacity alone. Transitioning care from inpatient to outpatient to those going to sub-acute rehabilitation facilities requires careful coordination of care. We present a trial of developing our own pulmonary rehabilitation service to patients discharged to our local rehabilitation facility. Methods: A total of 9 patients with AECOPD were discharged to our local rehabilitation facility and were enrolled into our COPD pulmonary rehabilitation program. These patients received physical therapy (PT) 7 days a week that was developed by our PT department at our facility with particular focus on breathing techniques such as diaphragmatic and pursed lip breathing and relaxation techniques. In addition they received endurance, mobility and gait training. Their 6 minute walk tests, Borg dyspnea scales (15 grade scale) and stair progress was recorded before and after rehabilitation. Any patient care issues were discussed with a member of faculty from our pulmonary division with visits to the facility if required. Results: Currently there is only data available for 5 patients. 3 of the patients were female. The average age of these patients was 78 years old. All patients required supplemental oxygen therapy at baseline. The average stay at the facility was 31 days. The average increase in their 6 minute walk test was 14.3 meters. The average Borg score at baseline was 14.8 and 13 after therapy. There was an average increase in 12 steps their stair progress. Conclusion: The results of our trial to implement a pulmonary rehabilitation service at our local rehabilitation facility are promising, albeit with data from only 5 patients at present. Discharging patients directly from the hospital to a pulmonary rehabilitation facility can be a challenge and can delay discharge from the hospital. There was an increase in both their 6 minute walk tests and ability to climb stairs after an average stay of 31 days at the facility, which can be significant in these patients with high risk for exacerbation. They were all discharged to home with home services. In addition, all patients received continued COPD care with a pulmonologist from our faculty. These interventions may also help reduce hospital readmissions.