A Pulmonary Rehabilitation Decisional Score to Define Priority Access for COPD Patients

Table 1

Pulmonary Rehabilitation Decisional Score (PRDS).

ITEMS	Score
	0	1	2
Age, years	≤59	60–74	≥75
BMI, Kg/m^2	21–24	25–30	≤20 or ≥31
FEV1% pred.	≥65%	36–64%	≤35%
Dyspnea, MRC score (0–4)	0-1	=2	≥3
6MWT, meters	≥350	≤349 and ≥250	≤249
CAT score	≤9	10–15	≥16
Comorbidities	0	1	1 if cardiac/neurological or >1
Activity of daily life	Normal	Limited	Bedridden/wheelchair-restricted
Severe exacerbations in the last year	0	1	>1
Hospitalizations in the last year	0	0, but 1 ER access	>0 or 2 ER access instances
Smoking status	Nonsmoker	Ex-smoker	Current smoker
Physical activity (cyclette, walking, steps)	>4 h/week	2–4 h/week	<2 h/week
Subjective wellbeing	Very well/good	Poor	bad
Depression	No medications	Occasional medications	Under chronic therapy
Anxiety	No medications	Occasional medications	Under chronic therapy
Care need and availability	Not necessary	Useful and available full time	Useful but available on spot or unavailable
Adherence to medications/oxygen	Full	Not constant	Poor/refusal to comply

FEV₁ = forced expiratory volume at first second; MRC = Medical Research Council; ER = emergency room; W = week; BMI = body mass index; CAT = COPD Assessment Tool; 6MWT = 6-min walking test. Consensus was considered when more than 75% of the respondents (a) rated each item as mandatory to be inserted in the score when considered “important” and/or “very important” and (b) agreed to each item’s grading from 0 = minimum to 2 = maximum priority indication for PR. Exacerbation was defined as “an event requiring antibiotics and/or oral steroids as prescribed by specialist or patient’s GP.”