Can the Rome classification of chronic obstructive pulmonary disease exacerbation severity be applied in the hospital setting?

Background: Chronic obstructive pulmonary disease (COPD) exacerbations (ECOPDs) are crucial events in the natural history of the disease. The recent Rome proposal defines exacerbations and their grade of severity using objective parameters derived from published data.

Aims: A) To evaluate the applicability of the Rome proposal in current clinical practice in different hospitals settings, B) to compare the resulting degree of severity with the conventional non-objective classification, C) to evaluate the relationship between ECOPD severity and mortality and D) the outputs in different hospital specialist wards.