Glucocorticoid Use in Patients Hospitalized with Chronic Obstructive Pulmonary Disease Exacerbations

Figures & data

Table 1 Characteristics at Baseline and Outcomes of the Study Population Over Two Periods

	2010–2016 (n=640)	2017–2020 (n=452)	P
Demographics
Age (years)	77.00±9.12	75.38±10.43	0.831
Male	457 (71.4%)	335 (74.1%)	0.323
GOLD C/D Group	438 (68.4%)	206 (45.6%)	<0.001
History of smoking	494 (77.2%)	272 (60.2%)	<0.001
Use of ICS at stable stage	84 (13.1%)	88 (19.5%)	0.005
Glucocorticoids use
ICS use without systemic corticosteroids	346 (54.1%)	271 (60.0%)	0.045
Systemic corticosteroids use without ICS	7 (1.1%)	6 (1.3%)	0.726
ICS+systemic corticosteroids use	176 (27.5%)	69 (15.3%)	<0.001
Systemic glucocorticoids use	183	75
Dose of systemic glucocorticoids (mg)
40–200	105 (57.4%)	51 (68.0%)
201–400	64 (35.0%)	19 (25.3%)
401–1184	14 (7.7%)	5 (6.7%)
Days of systemic glucocorticoids treatment (days)
1–5	75 (41.0%)	48 (64.0%)
6–14	89 (48.6%)	21 (28.0%)
15–31	19 (10.4%)	6 (8.0%)
Outcomes
Respiratory Failure	173 (27%)	119 (26.3%)	0.796
Mechanical ventilation	60 (9.4%)	47 (10.4%)	0.575
Hospital duration (days)	10.67±9.82	9.43±7.08	0.022
Intrahospital mortality	17 (2.7%)	11 (2.5%)	0.855
Recurrence within 30 d after discharge	26 (4.2%)	21 (5.5%)	0.617
Recurrence within 1 year after discharge	202 (32.4%)	91 (20.9%)	<0.001

Notes: Data are shown as mean ± SD, median (IQR), or n (%); P<0.05 are shown as bold letters.

Table 2 Factors Associated with Glucocorticoids Use Among Hospitalized Patients with AECOPD (Data of 2010–2016)

Variables	Univariable Logistic Regression			Multivariable Logistic Regression
	OR	95% CI	P	OR	95% CI	P
Sex (male)	1.659	1.011–2.722	0.045
Age	1.013	0.991–1.035	0.256
History of smoking	0.980	0.601–1.599	0.936
History of chronic cough	1.022	1.005–1.039	0.009
High-risk patients	2.926	1.925–4.480	<0.001	2.218	1.322–3.424	0.002
>1 AECOPD within the previous 12 month	2.447	1.431–4.184	0.001	1.681	0.934–3.026	0.083
Use of ICS at stable stage	1.300	0.679–2.486	0.428
Fever	1.265	0.833–1.919	0.270
Bronchial asthma	1.817	1.016–3.251	0.044
Hypertension	1.526	1.012–2.303	0.044	1.599	1.047–2.443	0.030
Type 2 diabetes	1.345	0.787–2.297	0.278
Old tuberculosis	0.794	0.496–1.272	0.337
Ischemic heart disease	0.864	0.573–1.304	0.486
Osteoporosis	0.905	0.363–2.252	0.829
Count of WBC	0.997	0.943–1.054	0.916
Percentage of Neutrophils	1.019	1.002–1.037	0.032
Count of Neutrophils	1.013	0.953–1.076	0.688
Percentage of Eosinophils	1.000	0.939–1.066	0.994
Count of Eosinophils	0.839	0.416–1.694	0.625
PaO2 (mmHg)	0.998	0.991–1.006	0.637
PaCO2 (mmHg)	1.023	1.010–1.037	0.001	1.016	1.001–1.032	0.032
Exudation on chest CT	0.933	0.578–1.505	0.775
Chronic bronchitis on chest CT	1.062	0.689–1.636	0.785

Note: P<0.05 are shown as bold letters.

Abbreviations: AECOPD, acute exacerbations of COPD; ICS, inhaled corticosteroid; WBC, white blood cell; CT, computed tomography.

Table 3 Factors Associated with Glucocorticoids Use Among Hospitalized Patients with AECOPD (Data of 2017–2020)

Variables	Univariable Logistic Regression			Multivariable Logistic Regression
	OR	95% CI	P	OR	95% CI	P
Sex (male)	1.256	0.752–2.098	0.384
Age	0.982	0.961–1.003	0.094
History of smoking	1.411	0.909–2.189	0.125
History of chronic cough	1.002	1.000–1.003	0.034
High-risk patients	2.093	1.323–3.313	0.002
>1 AECOPD within the previous 12 month	2.358	1.486–3.743	<0.001	2.038	1.192–3.484	0.009
Use of ICS at stable stage	4.323	1.931–9.678	<0.001	3.424	1.277–9.180	0.014
Fever	0.465	0.298-0.0725	0.001
Bronchial asthma	6.890	2.718–17.462	<0.001	5.448	1.880–15.791	0.002
Hypertension	1.584	1.023–2.454	0.039	2.186	1.299–3.676	0.003
Type 2 diabetes	1.293	0.748–2.235	0.357
Old tuberculosis	0.657	0.395–1.092	0.105
Ischemic heart disease	0.975	0.625–1.522	0.975
Osteoporosis	0.914	0.377–2.213	0.842
Count of WBC	0.981	0.918–1.048	0.566
Percentage of Neutrophils	1.000	0.981–1.020	0.989
Count of Neutrophils	0.980	0.914–1.050	0.562
Percentage of Eosinophils	1.129	1.004–1.270	0.043	1.169	1.016–1.344	0.029
Count of Eosinophils	0.943	0.432–2.057	0.882
PaO2 (mmHg)	1.000	0.988–1.011	0.965
PaCO2 (mmHg)	1.037	1.010–1.065	0.007	1.026	0.996–1.054	0.055
Exudation on chest CT	0.879	0.606–1.276	0.498
Chronic bronchitis on chest CT	1.508	1.016–2.236	0.041	1.564	0.970–2.522	0.067

Notes: P<0.05 are shown as bold letters.

Abbreviations: AECOPD, acute exacerbations of COPD; ICS, inhaled corticosteroid; WBC, white blood cell; CT, computed tomography.