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Inhaled corticosteroids and the risk of mortality and readmission in elderly patients with chronic obstructive pulmonary disease.
- Source :
-
American journal of respiratory and critical care medicine [Am J Respir Crit Care Med] 2001 Aug 15; Vol. 164 (4), pp. 580-4. - Publication Year :
- 2001
-
Abstract
- There is considerable controversy concerning the utility of inhaled corticosteroids for the long-term treatment of patients with COPD. Recent studies have suggested that although inhaled corticosteroids do not alter the rate of decline in lung function, they may reduce airway hyperresponsiveness, decrease the frequency of exacerbations, and slow the rate of decline in the patients' health status. The relationship between inhaled corticosteroids and subsequent risk of hospitalization or mortality remains unknown. We therefore conducted a population-based cohort study using administrative databases in Ontario, Canada (n = 22,620) to determine the association between inhaled corticosteroid therapy and the combined risk of repeat hospitalization and all-cause mortality in elderly patients with COPD. Patients who received inhaled corticosteroid therapy postdischarge (within 90 d) had 24% fewer repeat hospitalizations for COPD (95% confidence interval [CI], 22 to 35%) and were 29% less likely to experience mortality (95% CI, 22 to 35%) during 1 yr of follow-up after adjustment for various confounding factors. This cohort study has suggested that inhaled corticosteroid therapy is associated with reduced COPD-related morbidity and mortality in elderly patients. Although not definitive, because of the observational nature of these findings, these data provide a compelling rationale for a large randomized trial to determine the effect of inhaled corticosteroids on COPD-related morbidity and mortality.
- Subjects :
- Administration, Inhalation
Age Distribution
Age Factors
Aged
Cause of Death
Comorbidity
Female
Follow-Up Studies
Humans
Lung Diseases, Obstructive classification
Lung Diseases, Obstructive complications
Male
Morbidity
Ontario epidemiology
Population Surveillance
Proportional Hazards Models
Risk Factors
Severity of Illness Index
Steroids
Survival Analysis
Treatment Outcome
Anti-Inflammatory Agents therapeutic use
Lung Diseases, Obstructive drug therapy
Lung Diseases, Obstructive mortality
Patient Readmission statistics & numerical data
Subjects
Details
- Language :
- English
- ISSN :
- 1073-449X
- Volume :
- 164
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- American journal of respiratory and critical care medicine
- Publication Type :
- Academic Journal
- Accession number :
- 11520719
- Full Text :
- https://doi.org/10.1164/ajrccm.164.4.2009033