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Optimal glucocorticoid dose and the effects on mortality, length of stay, and readmission rates in patients diagnosed with acute exacerbation of chronic obstructive pulmonary disease (AECOPD)
  1. Asim Kichloo1,
  2. Michael Aljadah1,2,
  3. Navya Vipparla1,2,
  4. Farah Wani1,3
  1. 1 Department of Internal Medicine, Central Michigan University, Saginaw, Michigan, USA
  2. 2 Internal Medicine, Central Michigan University, Saginaw, Michigan, USA
  3. 3 Department of Internal Medicine, St Mary’s Hospital, Saginaw, Michigan, USA
  1. Correspondence to Dr Asim Kichloo, CMU Medical Education Partners, Saginaw, MI 48602, USA; kichlooasim{at}gmail.com

Abstract

The burden of acute exacerbation of chronic obstructive pulmonary disease (AECOPD) is staggering on a national and global level. Yet, surprisingly, there is a profound lack of treatment standardization with glucocorticoids in the treatment of AECOPD. In this review, we bring attention to specific literature that use a cut-off of 60 mg prednisone equivalent per day when distinguishing between high-dose and low-dose glucocorticoid treatment. We hope this review encourages future research to begin incrementally lowering the cut-off dose of 60 mg to discover if mortality, length of hospital stays, and readmission rates change between high-dose and low-dose glucocorticoid treatment. The final hope would be to establish an optimal glucocorticoid dose to treat AECOPD and eliminate treatment ambiguity.

  • pulmonary disease
  • chronic obstructive
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Footnotes

  • Contributors AK contributed substantially to the design of the work. MA contributed to acquisition, analysis and interpretation of data and drafted the paper. NV contributed to the design of the paper and interpretation of the data. FW contributed to the final revision of the important additions to the design of the work and drafted the final revision. AK, MA and NV contributed to the revision of critically important intellectual content and agreement of accountability for all aspects of the work. All authors contributed to the final approval of the version to be published.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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