Intravenous and oral corticosteroids for the prevention of relapse after treatment of decompensated COPD. Effect on patients with a history of multiple relapses.
To determine if a regimen of intravenous and oral corticosteroids reduces the relapse rate after treatment of decompensated COPD in the ED, 30 patients were studied. Forty-five visits in which intravenous and oral corticosteroids were given (T visits) were compared with an equal number of matched visits in which they were withheld (N visits). No differences were noted between T and N visits with respect to clinical findings, laboratory results and other forms of therapy. Treatment with corticosteroids reduced the relapse rate within 24 h of discharge. At 48 h, the cumulative relapse rate for T visits (8.9 percent) was significantly lower than for N visits (33.3 percent; p = 0.005). For patients with a history of multiple relapses, a regimen consisting of intravenous and oral corticosteroids reduces the risk of relapse after ED treatment of decompensated COPD.
Ambulatory Care Service, Veterans Affairs Medical Center, Albuquerque 87111.
G H
GH
Murata
M S
MS
Gorby
T W
TW
Chick
A K
AK
Halperin
D000208:Acute Disease; D000284:Administration, Oral; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage* / Q000627:therapeutic use; D000368:Aged; D001993:Bronchodilator Agents / Q000627:therapeutic use; D004636:Emergency Service, Hospital; D005541:Forced Expiratory Volume / Q000187:drug effects; D006801:Humans; D006854:Hydrocortisone / Q000008:administration & dosage / Q000627:therapeutic use; D007275:Injections, Intravenous; D008173:Lung Diseases, Obstructive / Q000188:drug therapy* / Q000503:physiopathology; D008775:Methylprednisolone / Q000008:administration & dosage / Q000627:therapeutic use; D011241:Prednisone / Q000008:administration & dosage / Q000627:therapeutic use; D012008:Recurrence; D012189:Retrospective Studies; D014797:Vital Capacity / Q000187:drug effects
D000305:Adrenal Cortex Hormones; D001993:Bronchodilator Agents; D011241:Prednisone; D006854:Hydrocortisone; D008775:Methylprednisolone