INVESTIGATION OF PROPER STEROID USE DURING ACUTE CHRONIC OBSTRUCTIVE PULMONARY EXACERBATIONS (AECOPD) ADMISSIONS AT A COMMUNITY TEACHING HOSPITAL

PURPOSE: This was a retrospective analysis to evaluate proper administration of steroids during AECOPD. The purpose of this study is to see if there is a correlation between average daily steroid dosage (oral and parenteral) and readmission rates for AECOPD. We also wanted to see how closely closely in accordance we were with the Global Initiative for Chronic Obstructive Lung Disease GOLD 2018 guidelines. METHODS: We took a retrospective glance at all AECOPD admissions from November 1st, 2017 to February 28th 2018. We examined the amount of steroids being administered on admissions. We then looked to see how compliant we were to the current guidelines and if those that were given more than the recommended dose had a difference in readmission rates. RESULTS: There were a total of 83 admissions for AECOPD of which 46 were given over the recommended 40 mg IV/PO corticosteroids daily. We had a total of 13 readmissions. Of those, 4 of 13 were given the standard dosing during their initial admission and 9 were given over the recommended guidelines. CONCLUSIONS: Giving more than the recommended 40 mg of steroids daily did not improve readmission rates. These results suggest that we ought to base our treatment regimen in accordance with recommended guidelines. CLINICAL IMPLICATIONS: We will use this data as the basis of a quality improvement project to promote more responsible steroid prescribing regimens that are more are closely in accordance with Global Initiative For Chronic Obstructive Lung Disease GOLD 2018.