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In-Hospital Mortality and Long-term Use of Inhaled Corticosteroids—Reply
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In reply
Dr Punnam asks if systemic corticosteroid or ICS use prior to admission for acute exacerbations of COPD influenced inpatient mortality. The objectives of our study1 were to obtain a generalizable estimate of in-hospital COPD mortality and to identify high-risk groups using readily available administrative data. Determining the impact of specific therapies on hospital outcomes was not one of our goals and unfortunately cannot be addressed with the data source used in our study (the Nationwide Inpatient Sample [NIS] does not contain information about medications on hospital admission).
A number of clinical trials have reported benefits of systemic corticosteroids for the treatment of COPD exacerbations (eg, improved pulmonary function and reduced rates of reexacerbations). To our knowledge, there are no clinical trial data to indicate that systemic corticosteroid use reduces mortality from COPD exacerbations. Evidence from clinical trials suggests that long-term ICS use does not delay the progressive loss . . . [Full Text of this Article]
Susheel P. Patil, MD;
Jerry A. Krishnan, MD;
Noah Lechtzin, MD, MHS;
Gregory B. Diette, MD, MHS
Baltimore, Md
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