Patients with acute exacerbation of COPD require admission to the hospital if they fail to improve adequately or deteriorate in spite of medical therapy, if they have significant comorbid illnesses, or they are without an intact social support system at home. The primary goals of hospitalization are to manage the acute exacerbation, prevent further deterioration, and educate patients on the nature the disease, current use of medications, and how to deal with the limitations presented by the disease and future exacerbations.
Objective criteria regarding hospital admission, observation unit stay, and emergency department discharge are lacking. Patients with an FEV 1 of 40 percent or more predicted or no clinical evidence of respiratory distress after treatment have a low rate of relapse and may be safely discharged home. 31 The ATS has developed consensus indications for hospitalization of patients with COPD ( T§bJe„„65,:l).
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