Category: Pulmonary Function

Inhaled Corticosteroids and Mortality in COPD: Recommendation

The reduction in all-cause mortality that we found was of similar magnitude to that observed in other cohort studies and was present in time-dependent analyses that were comparable to those that produced negative results. Randomized trials of ICSs in COPD patients have not shown significant mortality effects, but pooled data from these trials have shown…

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Inhaled Corticosteroids and Mortality in COPD: Conclusion

Our study has a number of strengths. It examined a large unselected population of patients, including those < 65 years of age, using a comprehensive database. We attempted to assess and adjust for comorbidities and disease severity by examining the use of other respiratory drugs and physician exposure. Excluding patients with a previous diagnosis of…

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Inhaled Corticosteroids and Mortality in COPD: Discussion

To ascertain the relationship between the length of time ICSs were used and mortality, we carried out nested case-control analyses examining a series of time frames. Subjects (n = 503) > 65 years of age who died within 90 to 365 days of hospital discharge were compared to age-matched and gender-matched control subjects who survived…

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Inhaled Corticosteroids and Mortality in COPD: Research

In the cohort analysis, subjects were classified into ICS users and nonusers on the basis of drug dispensation in the 90 days following discharge from the hospital. Subsequently, the two groups differed substantially in terms of the receipt of ICSs; 79.5% of those classified as users at 90 days had filled a prescription for ICSs…

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Inhaled Corticosteroids and Mortality in COPD: Results

Among 1,007 subjects between 35 and 64 years of age, 42 (4.1%) died within the first 90 days and were excluded from the analysis. The remaining 965 subjects were divided into the following two groups: 369 subjects (38.2%) who received ICSs within 90 days of discharge from the hospital; and 596 subjects (61.8%) who did…

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Inhaled Corticosteroids and Mortality in COPD: Statistical Analysis

In a nested case-control analysis, subjects who died within 90 to 365 days of hospital discharge were compared with respect to ICS exposure before death (ie, the index date) to age-matched and gender-matched control subjects who had survived to the same point in time. It was thus possible for the same individual to be both…

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Inhaled Corticosteroids and Mortality in COPD: Subjects

We identified all people who had been admitted to the hospital between April 1, 1996, and March 31, 2000, and had been discharged from the hospital with a primary diagnosis of COPD (ie, International Classification of Diseases, ninth revision [ICD-9], codes 490 [not otherwise specified bronchitis], 491 [chronic bronchitis], 492 [emphysema], and 496 [chronic airflow…

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Inhaled Corticosteroids and Mortality in COPD

Several studies have examined the course of COPD patients to whom inhaled corticosteroids (ICSs) were prescribed. In four studies, ICSs were prescribed within 90 days after discharge from the hospital for a COPD exacerbation, which is a time of relative instability when the risk for hospital readmission or death is high and therapy with ICSs…

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Etiology and Outcomes of Pulmonary and Extrapulmonary Acute Lung Injury/ARDS in a Respiratory ICU in North India: Discussion

In our study, although patients with ALI/ARDSexp were younger and sicker (ie, higher baseline and maximum SOFA scores) than their ALI/ARDSp counterparts, we found no difference in the occurrence of new organ dysfunction/failure (ie, ASOFA scores), time to the development of the first organ dysfunction/organ failure, the duration of RICU stay, and length of hospital…

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Etiology and Outcomes of Pulmonary and Extrapulmonary Acute Lung Injury/ARDS in a Respiratory ICU in North India: Results

Patients with ALI/ ARDSexp had higher maximum SOFA scores, but the ASOFA (signifying the new-onset organ dysfunction and/or organ failure) scores were similar in the two groups (Table 2). Similarly, there was no difference between the two groups in terms of the length of time to the first development of nonpulmonary organ dysfunction and organ…

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