Optimal glucocorticoid dose and the effects on mortality, length of stay, and readmission rates in patients diagnosed with acute exacerbation of chronic obstructive pulmonary disease (AECOPD)

J Investig Med. 2019 Dec;67(8):1161-1164. doi: 10.1136/jim-2019-001105. Epub 2019 Sep 24.

Abstract

The burden of acute exacerbation of chronic obstructive pulmonary disease (AECOPD) is staggering on a national and global level. Yet, surprisingly, there is a profound lack of treatment standardization with glucocorticoids in the treatment of AECOPD. In this review, we bring attention to specific literature that use a cut-off of 60 mg prednisone equivalent per day when distinguishing between high-dose and low-dose glucocorticoid treatment. We hope this review encourages future research to begin incrementally lowering the cut-off dose of 60 mg to discover if mortality, length of hospital stays, and readmission rates change between high-dose and low-dose glucocorticoid treatment. The final hope would be to establish an optimal glucocorticoid dose to treat AECOPD and eliminate treatment ambiguity.

Keywords: chronic obstructive; pulmonary disease.

MeSH terms

  • Disease Progression*
  • Dose-Response Relationship, Drug
  • Glucocorticoids / therapeutic use*
  • Humans
  • Length of Stay*
  • Patient Readmission / statistics & numerical data*
  • Placebos
  • Pulmonary Disease, Chronic Obstructive / diagnosis
  • Pulmonary Disease, Chronic Obstructive / drug therapy*
  • Pulmonary Disease, Chronic Obstructive / mortality*

Substances

  • Glucocorticoids
  • Placebos