Abstract
Background:
COPD exacerbations are an important cause of morbidity and mortality. Studies have reported inconclusive results regarding the use of oral corticosteroids in improving the clinical symptoms and reducing the risk of readmission to the hospital. The aim of this study, therefore, was to examine the effect of using oral corticosteroids on reducing emergency revisit of acute exacerbation.
Methods:
An observational study was been carried out at the emergency department (ED) in tertiary care hospital in Saudi Arabia between 2016 and 2018. A cohort of COPD adult patients who received oral corticosteroids in the hospital or ED and discharged were followed for any subsequent ED visit due to COPD exacerbation. We defined revisit if the date of the subsequent ED visit was within 60 days from the first ED discharge. Demographic and clinical information for each patient was collected from their electronic medical file. This research was approved by King Abdullah International Medical Research Center and registered with protocol number SP19.148.R.
Results:
A total of 325 COPD patients were presented to the ED and received oral corticosteroid in their first ED visit. The majority of the cohort (71%) had no subsequent ED visit during the study period, and 94(28%) patients had a repeat ED visit for COPD exacerbation, in which 61% of those came to ED within 60 days. The mean age of those patients was 75±10 years, and 58 % of these patients were female. Prednisolone was the most common type of oral corticosteroid given in this analysis (93%), followed by hydrocortisone (3%). Patients who had subsequent ED visits were more likely to have cardiovascular disease than those who had an ED revisit (51% vs. 45%, P-value 0.64).
Conclusions:
The use of oral corticosteroids could potentially reduce the severity of COPD exacerbation, and subsequent ED revisit. This could have a significant health policy
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