Hospice Guidelines For Determining Prognosis Pulmonary Disease

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Introduction

• severity of chronic lung disease, documented by

• disabling dyspnea at rest, poorly responsive to broncho- dilators
• FEV1 of < 30% of predicted (after bronchodilator) or a decrease in FEV1 of > 40 mL/year
• increasing visits to Emergency Department or hospitalizations

• right heart failure ( cor pulmonale) due to pulmonary disease

• documented by

• echocardiogram
• electrocardiogram
• chest X-ray
• physical signs of right heart failure

• hypoxemia at rest on supplemental oxygen

• paO2 =< 55 mm Hg on supplemental oxygen
• O2 saturation =< 88% on supplemental oxygen

• hypercapnia: pCO2 > 50 mm Hg
• unintentional, progressive weight loss of > 10% body weight over preceding 6 months
• resting tachycardia > 100/min

More General Terms

• hospice guidelines for determining prognosis

References

Medical Guidelines for Determining Prognosis in non-Cancer Diseases, 2nd edition, Stuart et al (eds), National Hospice Organization, Arlington, VA, 1996

hospice guidelines for determining prognosis, pulmonary disease