P-832. MeMed BV in Management of Adults Presenting with COPD Exacerbation to the ED: A Single-Center, Real-World Study

TL;DR

A study shows that using a blood test called MeMed BV in emergency departments helps doctors decide when to prescribe antibiotics for COPD flare-ups, reducing unnecessary use.

Contribution

This is the first real-world study showing MeMed BV's impact on antibiotic use and patient outcomes in COPD exacerbations in the ED.

Findings

MeMed BV achieved 100% concordance in discharging patients without unnecessary antibiotics for viral cases.

Antibiotic use aligned with test results in 75.3% of admitted patients.

No unplanned ED revisits occurred for patients with non-equivocal MeMed BV results.

Abstract

Distinguishing between bacterial and viral etiologies in emergency department (ED) patients remains a clinical challenge, particularly for COPD exacerbations.

MeMed BV® (MMBV) is an FDA-cleared host-protein test that provides a score (0-100) indicating bacterial (or bacterial co-infection) versus viral (or other non-bacterial) infections, with sensitivity and specificity >90%. This study examined MMBV’s integration into routine ED workflows for COPD exacerbations.

A single center, real-world study, where MMBV was incorporated into ED guidelines for managing adult patients with COPD exacerbation. Clinicians were trained to consider MMBV scores as: < 35 (viral/other non-bacterial), 35–65 (equivocal), and >65 (bacterial or co-infection). In this preliminary analysis (April-September 2024), inclusion criteria were COPD diagnosis, age ≥18 and ED presentation with respiratory complaints. Main exclusion criteria were trauma or non-COPD-related exacerbations. Data were prospectively collected on patient demographics, medical history, lab results, treatment course, hospitalization, and ED revisits (within 7-days).

MMBV concordance was defined as not prescribing antibiotics for viral results and prescribing antibiotics for bacterial results. Outcomes were analyzed separately for admitted and discharged patients.

Analysis included 128 patients (median age 71, IQR: 59–83), with 79.7% aged ≥65 and 32.0% female. MMBV results were bacterial in 60 (46.5%) patients, equivocal in 26 (20.1%), and viral in 43 (33.3%).

Twenty-two patients (17.1%) were discharged from the ED: 3 had bacterial results (all prescribed antibiotics), 6 had equivocal and 13 had viral results (none prescribed antibiotics); representing 100% MMBV concordance. None of the patients with non-equivocal MMBV results had unplanned ED revisits.

Among 106 admitted patients, 57 had bacterial results (70.2% received antibiotics), 20 had equivocal results (40.0% received antibiotics), and 29 had viral results (17.2% received antibiotics); representing 75.3% MMBV concordance.

Incorporating MMBV into routine ED care for COPD exacerbations is associated with targeted antibiotic use and safe discharges.

Tanya Gottlieb, PhD, MeMed Diagnostic: Employee