P228 Hospital at home for hypoxaemic patients: extending the remit of community respiratory care

BackgroundThe Knowsley Community Respiratory Service (KCRS) provides 24 hours per day, 7 days per week hospital at home support for patients with COPD. Current UK guidance1 recommends that patients with an arterial PaO2 of < 7kPa be managed in the hospital setting. Despite the current recommendation, many patients declined hospitalization during an exacerbation. We wished to explore the safety of patients being managed at home despite lower arterial oxygen levels.AimsTo evaluate the outcome of patients with COPD exacerbations being managed at home with an arterial PaO2 of < 7.3Kpa. Group A: Pa02 6.7–6.99kpa, Group B: Pa02:7.0 – 7.3kpa.MethodsRetrospective data were evaluated over a period of 10 months for 103 patients. Smokers (37), Male:42% Female:58%, Mean age: 73, Mean predicted FEV1%: 42.8%. Group A & B Mean NEWS2:3Results79 avoided admission (77%) & 24 admitted (23%). Number of patients kept at home but admitted within 30 days is 6 (7.6%). Group A (37) were safely managed at home, Group B (42). More intervention required such as repeat ABG for patients managed at home in group A. Overall 17 patients received 02 titration to prevent a hospital admission (Group A: 10, Group B:7).Abstract P228 Figure 1Percentage of patients requiring oxygen titration, and subsequent outcomesConclusionThe community respiratory team supports patients to be managed at home safely with a lower Pa02 to avoid unnecessary hospital admission and provide early supported discharge.ReferenceChronic obstructive pulmonary disease in over 16s: diagnosis and management. NICE guideline December 2018.