Glucocorticoid Use in Patients Hospitalized with Chronic Obstructive Pulmonary Disease Exacerbations

IF 2.8 3区医学 Q1 Medicine

International Journal of Chronic Obstructive Pulmonary Disease Pub Date : 2024-02-12 DOI:10.2147/copd.s436326

Songsong Yu, Shuang Li, Jie Zhang, Qiuhong Fang

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引用次数: 0

Abstract

Objective of the Study: Systemic glucocorticoid therapy can improve the outcomes of acute exacerbation of chronic obstructive pulmonary disease (AECOPD). The study tried to investigate the use of glucocorticoids in AECOPD patients and the factors associated with the physicians’ choice.
Methodology: Patients with AECOPD over two periods were divided by the year of 2017 when GOLD and ERS/ATS Guideline for COPD were updated. Data of patients regarding the study was retrieved from medical records. Descriptive statistical analysis was used for the illustration of glucocorticoids use, and hypothesis testing for comparison over the periods.
Results: Between 2010 and 2016, the proportion of ICS use was 522/640 (81.6%) and 341/452 (75.4%) between 2017 and 2020. COPD severity (GOLD C/D classification), bronchial asthma, percentage of neutrophils, and higher PaCO₂ were factors associated with physicians’ prescription of systemic glucocorticoids between 2010 and 2016. While the use of ICS at the stable stage, counts of neutrophils, and higher PaCO₂ were influencing factors between 2017 and 2020. Over the two periods, 1-year recurrent rate decreased from 32.4% to 20.9%, with a significant statistical difference (P< 0.001).
Conclusion: The optimized use of glucocorticoids was found after the publishment of 2017 ERS/ATS Guideline for COPD, this improvement was associated with a decreased 1-year recurrence rate among AECOPD patients at our institution, underscoring the positive impact of guideline updates on patient outcomes.

Keywords: chronic obstructive pulmonary disease, acute exacerbation, glucocorticoids, treatment selection

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慢性阻塞性肺病恶化住院患者使用糖皮质激素的情况

研究目的：全身糖皮质激素治疗可改善慢性阻塞性肺疾病（AECOPD）急性加重期的预后。本研究试图调查 AECOPD 患者使用糖皮质激素的情况以及与医生选择相关的因素：以2017年GOLD和ERS/ATS慢性阻塞性肺疾病指南更新的时间为界，对两个时期的AECOPD患者进行划分。从病历中获取与研究相关的患者数据。描述性统计分析用于说明糖皮质激素的使用情况，假设检验用于各时期的比较：2010年至2016年间，使用ICS的比例为522/640（81.6%），2017年至2020年间为341/452（75.4%）。慢性阻塞性肺疾病严重程度（GOLD C/D 分级）、支气管哮喘、中性粒细胞百分比和较高的 PaCO2 是 2010 年至 2016 年期间医生开具全身性糖皮质激素处方的相关因素。而在 2017 年至 2020 年期间，稳定期使用 ICS、中性粒细胞计数和较高的 PaCO2 是影响因素。在这两个时期，1年复发率从32.4%降至20.9%，统计学差异显著（P< 0.001）：2017年ERS/ATS《慢性阻塞性肺疾病指南》发布后，糖皮质激素的使用得到了优化，这一改善与本院AECOPD患者1年复发率的降低相关，强调了指南更新对患者预后的积极影响。关键词：慢性阻塞性肺疾病；急性加重；糖皮质激素；治疗选择

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Journal of Chronic Obstructive Pulmonary Disease RESPIRATORY SYSTEM-

CiteScore

5.10

自引率

10.70%

发文量

372

审稿时长

16 weeks

期刊介绍： An international, peer-reviewed journal of therapeutics and pharmacology focusing on concise rapid reporting of clinical studies and reviews in COPD. Special focus will be given to the pathophysiological processes underlying the disease, intervention programs, patient focused education, and self management protocols. This journal is directed at specialists and healthcare professionals