![]() There were no significant differences in baseline symptoms, demographics, forced expiratory volume in 1 second (FEV 1) or comorbidities between stable versus unstable groups. Results: A total of 104 severe and very severe COPD patients met entry criteria, and were observed for 37,702 patient-days. Exacerbation-free days, time to first hospitalization, hospitalization rate, length of hospitalization, and all-cause mortality were assessed. Rates of PEFR change were used to characterize patients into stable and unstable groups determined by the distribution of slopes. Methods: This was a retrospective analysis of prospectively collected data using an electronic diary to record daily PEFR and symptoms in severe and very severe COPD patients. We hypothesized that individuals with greater variability in daily PEFR would signal an unstable patient population with worse outcomes. Peak expiratory flow rate (PEFR) monitoring could provide a daily objective measurement of lung function in COPD patients at home. Rationale: Chronic obstructive pulmonary disease, (COPD) is a major cause of morbidity and mortality in the United States.
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