ABSTRACT

Introduction: chronic obstructive pulmonary disease alarmingly contributes to mortality worldwide. Severe (requiring admission) and very severe (requiring intensive care) acute exacerbation are relevant events due to their impact on quality of life and survival. Different international guidelines propose recommendations for the in-hospital management of exacerbations, but there is a need to establish guidelines for discharge management protocol. The objective and importance of this consensus is to establish and offer recommendations to be included in a discharge protocol for severe and very severe exacerbation in order to reduce the risk of relapse, readmission or death in short and long term. Material and methods: a formal Consensus of experts was elaborated as an initiative of the Mexican Respiratory Society (Sociedad Mexicana de Neumología y Cirugía de Tórax) in collaboration with the Ibero-American Agency for the Development and Assessment of Health Technologies. A Development Group was created of multidisciplinary clinical experts and methodologists with experience in systematic reviews and clinical practice guidelines. The Modified Delphi Panel methodology was used, an agreed level was established at ≥ 70% by Likert score for each recommendation. Results: nine clinical questions were integrated that reflected the gaps in clinical practice in the management at discharge of exacerbation. The Delphi Panel shows that all recommendations reached a level of consensus (> 70%). Question 1 and 5 showed a mean < 8.0 and the rest a mean > 8.0 at the first panel round (three questions reached > 90%). Conclusion: we now have recommendations that provide guidance and information on controversies to integrate an appropriate discharge protocol.

KEYWORDS

acute exacerbation of COPD, discharge protocol for COPD, discharge consensus for COPD.

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