A Non-intervention Retrospective Study Of Treatment Status Of Inpatients With Acute Exacerbation Of Chronic Obstructive Pulmonary Disease

Objective: To assess the clinical practice,including treatmentusing glucocorticoids, in hospitalized patients with acuteexacerbation of chronic obstructive pulmonary disease(AECOPD), fora better and standard clinical management of AECOPD.Methods：Retrospectively analyzing the clinical material of254inpatients who were hospitalized into the Respiratory Department of2nd Hospital of Jilin University for AECOPD between1/6/2013and31/6/2014, including the general information as gender, age,hospitalized days, costs and to which medical team they assigned,percentage of the using of glucocorticoids and the route, dose andcourses, other pharmacologic treatments like bronchodilators,antibiotics and mucolytic agents are also refered. Statistical testswere made to compare the difference among the cases from differentmedical teams or treatment groups.Results:AECOPD still is one of the commonest made diagnosis inRespiratory Department, just following low-respiratory-trackinfections and malignancies. Patients usually are older, have tospend money and time in hospital over average level. The usage ofglucocorticoids for AECOPD are different between medical teams. Ofall the254cases,40.9%did not use any kind of glucocorticoids,23.6%used nebulized glucocorticoids,20.9%used systematicglucocorticoids,14.6%use inhaled glucocorticoids withmetered-dose inhaler(MDI).91.7%of the patients using nebulizedcorticoids received4mg/day(budesonide equivalents).92.4%of thepatients using systematic corticoids received40-80mg/day(methylprednisolone equivalents) and98%by IV. For those who usedsystematic corticoids, it costd more,faced more mechanicventilation，antibiotics and higher probability of death.Patientsdidn’t use any corticoids have shorter in-hospital time than othergroups but not nebulized group. Patients using corticoids by MDI wereyonger than those by nebulizatian, and used corticoids for a longer time during hospital than those by other two ways which has nodifferences in using-time between each other.94.0%of all cases usedbronchodilators, doxofylline by IV was preferred.99.6%of all caseused antibiotics， Semi-synthetic penicillin plus β-lactamaseinhibitor and Carbapenems were most commonly used. More than85.1%cases use kinds of mucolytic agents，ambroxol by IV is the major one.Conclusion:AECOPD still is one of the high-burdened diseasesoften seen in Respiratory Department. Clinical practice oftreatments in AECOPD did not followed clinical guidelines veryclosely.