Effectiveness of Steroid Therapy on Pneumonic Chronic Obstructive Pulmonary Disease Exacerbation: A Multicenter, Retrospective Cohort Study.

Abstract:

Purpose:To date, no consensus exists on the effects of systemic steroid use on pneumonic chronic obstructive pulmonary disease (COPD) exacerbation owing to trial design issues in previous trials involving these conditions. This multicenter study aimed to evaluate more precisely the effectiveness of the use of systemic steroids in treating pneumonic COPD exacerbation in a larger sample by adjusting for confounding factors. Patients and Methods:This multicenter, retrospective, observational study was conducted across five acute general hospitals in Japan. We analyzed the association between parenteral/oral steroid therapy and time to clinical stability in pneumonic COPD exacerbation. We used a validated algorithm derived from the 10th revision of the International Classification of Diseases and Related Health Problems (ICD-10) to include patients with pneumonic COPD exacerbation. We excluded patients with other hypoxia causes (asthma exacerbation, pneumothorax, heart failure) and complicated pneumonia (obstructive pneumonia, empyema), those who required tracheal intubation/vasopressors, and those who were clinically stable on day of admission. The primary outcome was the time to clinical stability. Multiple imputation was used for missing data. Propensity scores within each imputed dataset were calculated using potential confounding factors. The Fine and Gray model was used within each dataset to account for the competing risk of death and hospital discharge without clinical stability, and we combined the results. Results:Altogether, 1237 patients were included. Systemic steroid therapy was administered to 658 patients (53%). The pooled estimated subdistribution hazard ratio of time to clinical stability in steroid vs non-steroid users was 0.89 (95% confidence interval, 0.78 to 1.0). Conclusion:This study revealed that systemic steroid therapy may not improve the time to clinical stability in patients with pneumonic COPD exacerbation of mild to moderate severity. Further randomized controlled trials including more severe patients will be needed to evaluate the effectiveness of systemic steroid therapy accurately.

authors

Shiroshita A,Shiba H,Tanaka Y,Nishi A,Sato K,Shirakawa C,Kataoka Y

doi

10.2147/COPD.S271844

subject

Has Abstract

pub_date

2020-10-19 00:00:00

pages

2539-2547

eissn

1176-9106

issn

1178-2005

pii

271844

journal_volume

15

pub_type

杂志文章
  • Relationship between airway obstruction and incidence of metabolic syndrome in Korea: a community-based cohort study.

    abstract:Background:Although studies have examined the relationship between metabolic syndrome (MetS) and COPD, the incidence of MetS in individuals with COPD has not specifically been investigated. This study aimed to evaluate the incidence of MetS in subjects with airway obstruction using data from a community-based cohort. ...

    journal_title:International journal of chronic obstructive pulmonary disease

    pub_type: 杂志文章

    doi:10.2147/COPD.S157453

    authors: Kim CY,Park Y,Leem AY,Chung KS,Jung JY,Park MS,Kim YS

    更新日期:2018-06-28 00:00:00

  • Anemia and performance status as prognostic markers in acute hypercapnic respiratory failure due to chronic obstructive pulmonary disease.

    abstract:BACKGROUND:In patients with acute hypercapnic respiratory failure (AHRF) during exacerbations of COPD, mortality can be high despite noninvasive ventilation (NIV). For some, AHRF is terminal and NIV is inappropriate. However there is no definitive method of identifying patients who are unlikely to survive. The aim of t...

    journal_title:International journal of chronic obstructive pulmonary disease

    pub_type: 杂志文章

    doi:10.2147/COPD.S39403

    authors: Haja Mydin H,Murphy S,Clague H,Sridharan K,Taylor IK

    更新日期:2013-01-01 00:00:00

  • Normal lung attenuation distribution and lung volume on computed tomography in a Chinese population.

    abstract::Backgroud and objectives: Although lung attenuation distribution and lung volume on computed tomography (CT) have been widely used in evaluating COPD and interstitial lung disease, there are only a few studies regarding the normal range of these indices, especially in Chinese subjects. We aimed to describe the normal ...

    journal_title:International journal of chronic obstructive pulmonary disease

    pub_type: 杂志文章

    doi:10.2147/COPD.S187596

    authors: Cheng T,Li Y,Pang S,Wan H,Shi G,Cheng Q,Li Q,Pan Z,Huang S

    更新日期:2019-07-24 00:00:00

  • Clinical significance of laryngopharyngeal reflux in patients with chronic obstructive pulmonary disease.

    abstract:BACKGROUND:Although chronic obstructive pulmonary disease (COPD) is closely associated with gastroesophageal reflux disease (GERD), the clinical significance of laryngopharyngeal reflux (LPR) is not fully understood in COPD. METHODS:Prospective cohorts were established among 118 patients with COPD from March 2013 to J...

    journal_title:International journal of chronic obstructive pulmonary disease

    pub_type: 杂志文章

    doi:10.2147/COPD.S84337

    authors: Jung YH,Lee DY,Kim DW,Park SS,Heo EY,Chung HS,Kim DK

    更新日期:2015-07-15 00:00:00

  • Epidemiology of chronic obstructive pulmonary disease: a population-based study in Krasnoyarsk region, Russia.

    abstract:BACKGROUND:Krasnoyarsk region is a territory with the widespread risk factors for chronic obstructive pulmonary disease (COPD) such as tobacco smoke, air pollution, and occupational exposure. An assessment of COPD prevalence based on medical diagnosis statistics underestimates the true COPD prevalence. This study aims ...

    journal_title:International journal of chronic obstructive pulmonary disease

    pub_type: 杂志文章

    doi:10.2147/COPD.S79601

    authors: Artyukhov IP,Arshukova IL,Dobretsova EA,Dugina TA,Shulmin AV,Demko IV

    更新日期:2015-09-02 00:00:00

  • Enlightening chronic obstructive pulmonary disease through patients' and caregivers' narratives.

    abstract:Purpose:The primary aim of this research was to raise awareness for COPD through real narratives of patients, caregivers, and pulmonologists. The second objective includes providing clinicians new means of caring for and treating patients with COPD. Methods:Using narrative medicine, testimonies from patients, their ca...

    journal_title:International journal of chronic obstructive pulmonary disease

    pub_type: 杂志文章

    doi:10.2147/COPD.S172214

    authors: Gatti V,Banfi P,Centanni S,D'Antonio S,Giustini S,Piraino A,Zibellini M,Marini MG

    更新日期:2018-10-05 00:00:00

  • Distinct pain profiles in patients with chronic obstructive pulmonary disease.

    abstract:Background:Few studies have examined changes in the pain experience of patients with COPD and predictors of pain in these patients. Objectives:The objectives of the study were to examine whether distinct groups of COPD patients could be identified based on changes in the occurrence and severity of pain over 12 months ...

    journal_title:International journal of chronic obstructive pulmonary disease

    pub_type: 杂志文章,多中心研究

    doi:10.2147/COPD.S150114

    authors: Bentsen SB,Miaskowski C,Cooper BA,Christensen VL,Henriksen AH,Holm AM,Rustøen T

    更新日期:2018-03-06 00:00:00

  • The evaluation of β-adrenoceptor blocking agents in patients with COPD and congestive heart failure: a nationwide study.

    abstract:OBJECTIVE:β-Blockers are safe and improve survival in patients with both congestive heart failure (CHF) and COPD. However, the superiority of different types of β-blockers is still unclear among patients with CHF and COPD. The association between β-blockers and CHF exacerbation as well as COPD exacerbation remains uncl...

    journal_title:International journal of chronic obstructive pulmonary disease

    pub_type: 杂志文章

    doi:10.2147/COPD.S141694

    authors: Liao KM,Lin TY,Huang YB,Kuo CC,Chen CY

    更新日期:2017-08-26 00:00:00

  • Mixed Phenotype of Emphysema and Airway Wall Thickening Is Associated with Frequent Exacerbation in Chronic Obstructive Pulmonary Disease Patients.

    abstract:Objective:The presence of both emphysema and airway wall thickening determined via volumetric computed tomography (CT) is defined as mixed phenotype. The long-term clinical course of this phenotype has not been studied in depth. This study compared the mixed phenotype to other phenotypes of chronic obstructive pulmonar...

    journal_title:International journal of chronic obstructive pulmonary disease

    pub_type: 杂志文章

    doi:10.2147/COPD.S227377

    authors: Lim JU,Kim EK,Lim SY,Lee JH,Lee JS,Lee SD,Oh YM,Rhee CK,KOLD Study Group.

    更新日期:2019-12-30 00:00:00

  • The effect of domiciliary noninvasive ventilation on clinical outcomes in stable and recently hospitalized patients with COPD: a systematic review and meta-analysis.

    abstract:INTRODUCTION:Noninvasive ventilation (NIV) improves survival among patients with hypercapnic respiratory failure in hospital, but evidence for its use in domiciliary settings is limited. A patient's underlying risk of having an exacerbation may affect any potential benefit that can be gained from domiciliary NIV. This ...

    journal_title:International journal of chronic obstructive pulmonary disease

    pub_type: 杂志文章,meta分析,评审

    doi:10.2147/COPD.S104238

    authors: Dretzke J,Moore D,Dave C,Mukherjee R,Price MJ,Bayliss S,Wu X,Jordan RE,Turner AM

    更新日期:2016-09-16 00:00:00

  • Clinical application value of impulse oscillometry in geriatric patients with COPD.

    abstract:BACKGROUND:The diagnosis and assessment of COPD rely mainly on the use of spirometry, which is an effort-dependent test and requires good patient cooperation. Impulse oscillometry (IOS) is a non-volitional method that requires less effort and cooperation and presents advantages for geriatric patients. However, the clin...

    journal_title:International journal of chronic obstructive pulmonary disease

    pub_type: 杂志文章

    doi:10.2147/COPD.S129974

    authors: Liu Z,Lin L,Liu X

    更新日期:2017-03-15 00:00:00

  • Patient preferences in severe COPD and asthma: a comprehensive literature review.

    abstract:BACKGROUND:Management of chronic incurable diseases such as chronic obstructive pulmonary disease (COPD) and asthma is difficult. Incorporation of patient preferences is widely encouraged. PURPOSE:To summarize original research articles determining patient preference in moderate-to-severe disease. METHODS:Acceptable ...

    journal_title:International journal of chronic obstructive pulmonary disease

    pub_type: 杂志文章,评审

    doi:10.2147/COPD.S82179

    authors: Bereza BG,Troelsgaard Nielsen A,Valgardsson S,Hemels ME,Einarson TR

    更新日期:2015-04-08 00:00:00

  • Examining 30-day COPD readmissions through the emergency department.

    abstract:Background:Thirty-day readmission in COPD is common and costly, but potentially preventable. The emergency department (ED) may be a setting for COPD readmission reduction efforts. Objective:To better understand COPD readmission through the ED, ascertain factors associated with 30-day readmission through the ED, and id...

    journal_title:International journal of chronic obstructive pulmonary disease

    pub_type: 杂志文章

    doi:10.2147/COPD.S147796

    authors: Rezaee ME,Ward CE,Nuanez B,Rezaee DA,Ditkoff J,Halalau A

    更新日期:2017-12-27 00:00:00

  • An evaluation of activity tolerance, patient-reported outcomes and satisfaction with the effectiveness of pulmonary daoyin on patients with chronic obstructive pulmonary disease.

    abstract:BACKGROUND AND OBJECTIVE:Pulmonary Daoyin (PD) (evolved from ancient Chinese daoyin skills), is a rehabilitation technology that combines specially designed movements of the arms and body and controlled breathing exercises, to improve the physiological and psychological status of patients with chronic respiratory disea...

    journal_title:International journal of chronic obstructive pulmonary disease

    pub_type: 杂志文章,多中心研究,随机对照试验

    doi:10.2147/COPD.S117461

    authors: Zhang HL,Li JS,Yu XQ,Li SY,Halmurat U,Xie Y,Wang YF,Li FS,Wang MH

    更新日期:2017-08-04 00:00:00

  • Factors associated with exacerbation in mild- to-moderate COPD patients.

    abstract:INTRODUCTION:COPD exacerbation negatively impacts the patient's quality of life and lung function, increases mortality, and increases socioeconomic costs. In a real-world setting, the majority of patients with COPD have mild-to-moderate airflow limitation. Therefore, it is important to evaluate COPD exacerbation in pat...

    journal_title:International journal of chronic obstructive pulmonary disease

    pub_type: 杂志文章,多中心研究

    doi:10.2147/COPD.S105583

    authors: Kim JK,Lee SH,Lee BH,Lee CY,Kim do J,Min KH,Kim SK,Yoo KH,Jung KS,Hwang YI

    更新日期:2016-06-16 00:00:00

  • Psychometric properties of the Physical Activity Scale for the Elderly in Chinese patients with COPD.

    abstract:BACKGROUND:For patients with COPD, physical activity (PA) is recommended as the core component of pulmonary rehabilitation, but there is lack of a validated questionnaire for assessing the PA effectively. AIM:To evaluate the reliability and validity of the Chinese version of Physical Activity Scale for the Elderly (PA...

    journal_title:International journal of chronic obstructive pulmonary disease

    pub_type: 杂志文章

    doi:10.2147/COPD.S120700

    authors: Tao YX,Wang L,Dong XY,Zheng H,Zheng YS,Tang XY,Zhao Y,Zhang Q

    更新日期:2016-12-22 00:00:00

  • Pharmacoeconomics in COPD: lessons for the future.

    abstract::COPD exerts a substantial burden on health and health care systems globally and will continue to do so for the foreseeable future. Treatment however can be costly and health care providers are interested in both whether treatments can offer improvements in disease burden and whether they represent value for money. Eco...

    journal_title:International journal of chronic obstructive pulmonary disease

    pub_type: 杂志文章,评审

    doi:

    authors: Starkie HJ,Briggs AH,Chambers MG

    更新日期:2008-01-01 00:00:00

  • Airflow obstruction: is it asthma or is it COPD?

    abstract::Despite the availability of guideline recommendations, diagnostic confusion between COPD and asthma appears common, and often it is very difficult to decide whether the obstruction is caused by asthma or COPD in a patient with airway obstruction. However, there are well-defined features that help in differentiating as...

    journal_title:International journal of chronic obstructive pulmonary disease

    pub_type: 杂志文章,评审

    doi:10.2147/COPD.S54927

    authors: Rogliani P,Ora J,Puxeddu E,Cazzola M

    更新日期:2016-11-30 00:00:00

  • Bacterial load and inflammatory response in sputum of alpha-1 antitrypsin deficiency patients with COPD.

    abstract:Background:Airway inflammation may drive the progression of chronic obstructive pulmonary disease (COPD) associated with alpha-1 antitrypsin deficiency (AATD), but the relationship between airway microbiota and inflammation has not been investigated. Methods:We studied 21 non-treated AATD (AATD-noT) patients, 20 AATD-...

    journal_title:International journal of chronic obstructive pulmonary disease

    pub_type: 杂志文章

    doi:10.2147/COPD.S207203

    authors: Balbi B,Sangiorgi C,Gnemmi I,Ferrarotti I,Vallese D,Paracchini E,Delle Donne L,Corda L,Baderna P,Corsico A,Carone M,Brun P,Cappello F,Ricciardolo FL,Ruggeri P,Mumby S,Adcock IM,Caramori G,Di Stefano A

    更新日期:2019-08-21 00:00:00

  • A TASMAN Expedition: Development of a Questionnaire to Assess Specific Self-Management Abilities.

    abstract:Introduction:Self-management (SM) is a core component of well-being and perceived health for patients with chronic obstructive pulmonary disease (COPD). Most theories on SM share that self-efficacy, illness-perception and coping are determinants of SM behavior. Optimal support to improve SM should be tailored to the in...

    journal_title:International journal of chronic obstructive pulmonary disease

    pub_type: 杂志文章

    doi:10.2147/COPD.S224943

    authors: Voorhaar M,Tiemensma J,Asijee GM,Slok AHM,Muris JWM,Kaptein AA

    更新日期:2020-06-19 00:00:00

  • Overlaps and uncertainties of smoking-related idiopathic interstitial pneumonias.

    abstract::Smoking-related interstitial lung disease (ILD) consists of a heterogeneous group of disorders that are considered a distinct entity. The 2013 American Thoracic Society and European Respiratory Society recommendations classified respiratory bronchiolitis (RB)/RB-ILD and desquamative interstitial pneumonia (DIP) as smo...

    journal_title:International journal of chronic obstructive pulmonary disease

    pub_type: 杂志文章,评审

    doi:10.2147/COPD.S146899

    authors: Bak SH,Lee HY

    更新日期:2017-11-01 00:00:00

  • Pulmonary adenocarcinoma mutation profile in smokers with smoking-related interstitial fibrosis.

    abstract::Cigarette smoking is an established cause of lung cancer. However, pulmonary fibrosis is also an independent risk factor for the development of lung cancer. Smoking-related interstitial fibrosis (SRIF) has recently been reported. We hypothesized that adenocarcinomas in lungs with SRIF might show distinct molecular cha...

    journal_title:International journal of chronic obstructive pulmonary disease

    pub_type: 杂志文章

    doi:10.2147/COPD.S61932

    authors: Primiani A,Dias-Santagata D,Iafrate AJ,Kradin RL

    更新日期:2014-05-24 00:00:00

  • A 1-year follow-up study exploring the associations between perception of illness and health-related quality of life in persons with chronic obstructive pulmonary disease.

    abstract::Chronic obstructive pulmonary disease (COPD) is a progressive respiratory disease with an increasing prevalence worldwide. Its potential consequences, including reduced function and reduced social participation, are likely to be associated with decreased health-related quality of life (HRQoL). However, illness percept...

    journal_title:International journal of chronic obstructive pulmonary disease

    pub_type: 杂志文章

    doi:10.2147/COPD.S52700

    authors: Bonsaksen T,Haukeland-Parker S,Lerdal A,Fagermoen MS

    更新日期:2014-01-01 00:00:00

  • Gender-specific estimates of COPD prevalence: a systematic review and meta-analysis.

    abstract:Rationale:COPD has been perceived as being a disease of older men. However, >7 million women are estimated to live with COPD in the USA alone. Despite a growing body of literature suggesting an increasing burden of COPD in women, the evidence is limited. Objectives:To assess and synthesize the available evidence among...

    journal_title:International journal of chronic obstructive pulmonary disease

    pub_type: 杂志文章,meta分析,评审

    doi:10.2147/COPD.S146390

    authors: Ntritsos G,Franek J,Belbasis L,Christou MA,Markozannes G,Altman P,Fogel R,Sayre T,Ntzani EE,Evangelou E

    更新日期:2018-05-10 00:00:00

  • Effect of background long-acting beta2-agonist therapy on the efficacy and safety of a novel, nebulized glycopyrrolate in subjects with moderate-to-very-severe COPD.

    abstract:Background:Phase III studies demonstrated efficacy and safety of nebulized glycopyrrolate inhalation solution (GLY) in subjects with COPD. Secondary analyses were performed to examine the effect of background long-acting beta2-agonist (LABA) use on the efficacy and safety of nebulized GLY. Methods:In two 12-week place...

    journal_title:International journal of chronic obstructive pulmonary disease

    pub_type: 杂志文章,多中心研究,随机对照试验

    doi:10.2147/COPD.S172408

    authors: Kerwin EM,Tosiello R,Price B,Sanjar S,Goodin T

    更新日期:2018-09-19 00:00:00

  • A gender difference in circulating neutrophils in malnourished patients with COPD.

    abstract:BACKGROUND:Circulating markers of inflammation in chronic obstructive pulmonary disease (COPD) may correlate to disease progression and extrapulmonary complications such as malnourishment. However, surprisingly little is known about gender-related differences for circulating inflammatory markers in COPD. PURPOSE:To ch...

    journal_title:International journal of chronic obstructive pulmonary disease

    pub_type: 杂志文章

    doi:10.2147/COPD.S15351

    authors: Larsson S,Nordenson A,Glader P,Yoshihara S,Lindén A,Slinde F

    更新日期:2011-01-01 00:00:00

  • Critical role of tumor necrosis factor receptor 1 in the pathogenesis of pulmonary emphysema in mice.

    abstract::COPD is a major cause of chronic morbidity and mortality throughout the world. Although tumor necrosis factor-α (TNF-α) has a critical role in the development of COPD, the role of different TNF receptors (TNFRs) in pulmonary emphysema has not been resolved. We aimed to clarify the role of TNFRs in the development of p...

    journal_title:International journal of chronic obstructive pulmonary disease

    pub_type: 杂志文章

    doi:10.2147/COPD.S108919

    authors: Fujita M,Ouchi H,Ikegame S,Harada E,Matsumoto T,Uchino J,Nakanishi Y,Watanabe K

    更新日期:2016-07-28 00:00:00

  • Respiratory health and quality of life in young exclusive, habitual smokers - a comparison of waterpipe smokers, cigarette smokers and non-smokers.

    abstract:Purpose:Waterpipe (WP) use has become a global trend in young populations. However, there are few well-controlled studies focusing specifically on the chronic effects of exclusive WP use on young adults' respiratory health. We sought to compare in young adults the burden of respiratory symptoms in regular WP smokers (W...

    journal_title:International journal of chronic obstructive pulmonary disease

    pub_type: 杂志文章,多中心研究

    doi:10.2147/COPD.S205050

    authors: Hawari FI,Obeidat NA,Abu Alhalawa M,Al-Busaidi Z,Amara B,Baddar S,Elhabiby M,Elkholy H

    更新日期:2019-08-13 00:00:00

  • Role of microparticles derived from monocytes, endothelial cells and platelets in the exacerbation of COPD.

    abstract:Background:Microparticles (MPs) are shedding membrane vesicles released from activated blood and endothelial cells under inflammatory conditions. The role of endothelial MPs (EMPs) in pathophysiology of COPD is relatively well known. However, the release and function of MPs of other cellular origins, eg, platelets, red...

    journal_title:International journal of chronic obstructive pulmonary disease

    pub_type: 杂志文章

    doi:10.2147/COPD.S175607

    authors: Tőkés-Füzesi M,Ruzsics I,Rideg O,Kustán P,Kovács GL,Molnár T

    更新日期:2018-11-15 00:00:00

  • Lack of paradoxical bronchoconstriction after administration of tiotropium via Respimat® Soft Mist™ Inhaler in COPD.

    abstract::Bronchoconstriction has been reported in asthma and chronic obstructive pulmonary disease (COPD) patients after administration of some aqueous inhalation solutions. We investigated the incidence of this event during long-term clinical trials of tiotropium delivered via Respimat(®) Soft Mist™ Inhaler (SMI). We retrospe...

    journal_title:International journal of chronic obstructive pulmonary disease

    pub_type: 杂志文章

    doi:10.2147/COPD.S16094

    authors: Hodder R,Pavia D,Lee A,Bateman E

    更新日期:2011-01-01 00:00:00