Impact of Prior Use of Inhaled Corticosteroids on the Clinical Outcomes of Obstructive Pulmonary Disease Patients Hospitalised with Community-Acquired Pneumonia
- VernacularTitle:既往吸入糖皮质激素对合并慢性阻塞性肺病的社区获得性肺炎住院患者预后的影响
- Author:
Liang1 CHEN
1
;
Xiu-di HAN
2
;
Yan-li LI
3
;
Chun-xiao ZHANG
4
;
Xi-qian XING
5
Author Information
1. Department of Infectious Disease，Beijing Jishuitan Hospital，Beijing 100096，China
2. Department of Pulmonary and Critical Care Medicine Qingdao Municipal Hospital，Qingdao 266011，China
3. Department of Infectious Disease and Clinical Microbiology，Beijing Chao-Yang Hospital，Beijing 100043，China
4. Department of Respiratory Medicine，Beijing Huimin Hospital，Beijing 100053，China
5. Department of Pulmonary and Critical Care Medicine， The 2nd People′s Hospital of Yunnan Province，Kunming 650021，China
- Publication Type:Journal Article
- Keywords:
inhaled corticosteroids, obstructive pulmonary disease, community- acquired pneumonia, clinical outcome
- From:
Journal of Sun Yat-sen University(Medical Sciences)
2019;40(6):881-888
- CountryChina
- Language:Chinese
-
Abstract:
【Objective】To evaluate the impact of prior use of inhaled corticosteroids（IC）on the clinical outcomes of chronic obstructive pulmonary disease patients hospitalised with community- acquired pneumonia （COPD- CAP）. 【Methods】This was a multicenter，retrospective study. Data of COPD-CAP patients from five teaching hospitals in Beijing，Shandong and Yunnan Provinces during 1st January 2013 through 31th December 2016 were reviewed. The patients with and without prior use of IC were compared，including demographic characteristics，clinical and radiologic features， and outcomes. A logistic regression model was conducted to explore the impact of prior IC use on the clinical outcomes of COPD-CAP patients. 【Results】Of 725 patients included in the study，13.9%（101/725）were prior IC users. Compared with no-IC users，IC users showed higher frequency of cardiovascular comorbidity（19.8% vs 12.7%）and a CAP history in the last year（20.8% vs 11.2%）；lower occurrence of pleural effusion（13.9% vs 23.7%）；more often classified in Global Initiative for Chronic Obstructive Lung Disease（GOLD）stage 3（35.1% vs 22.9%）and GOLD 4 stage（51.9% vs 21.8%），less often in GOLD 2 stage（10.4% vs 51.0%）. Adjusted by age，gender，underlying diseases，PSI/CURB-65 score and GOLD stage，logistic regression analysis confirmed prior IC use was associated with decreased risk for noninvasive ventilation［OR = 0.220，95% CI（0.052，0.926），P = 0.029］，but not with invasive ventilation［OR = 0.290，95% CI（0.068，1.236），P = 0.094］，needing vasopressor use［OR = 1.261，95% CI（0.456，3.485），P = 0.655］，ICU admission［OR = 1.455，95% CI（0.638，3.320），P = 0.373］and 30-day mortality［OR = 1.650，95% CI（0.575，2.838）， P = 0.352］.【Conclusion】Previous IC use has no major impact on the clinical outcomes of COPD-CAP patients.
