Audit of Duration of Corticosteroid Treatment in Acute Exacerbations of COPD

Background: GOLD guidelines recommend use of corticosteroids for 5-7 days in acute exacerbations of Chronic Obstructive Pulmonary Disease (COPD) as it improves lung function (FEV1), oxygenation and reduces duration of hospitalisation. We evaluated our local practice in a medium sized teaching hospital in the U.K compared to GOLD guidelines. Methods: Retrospective data of 57 patients admitted to Royal Preston Hospital from September- October 2016 with an acute exacaerbation of COPD was collected. Results: Mean age was 70.9 years(+/- SD 10.4); 32(56.14%) patients were female; mean duration of hospital stay was 5.5 days (+/- SD 5.9). Median FEV1 percent predicted (n=40) was 39.5%. Median duration of steroids was 7 days. For 3 patients on domicilliary non-invasive ventilation for COPD, median duration of prednisolone was 25days. 35 patients(66%) received 50% predicted, n=15). We did not find statistically significant differences in length of hospital stay between patients receiving prolonged course (> 7days) of steroids compared to those receiving a shorter course ( Conclusion: 66% of patients are treated with steroids according to current guidelines. Patients with frequent exacerbations of COPD receive longer courses of steroid. Work is underway to address these issues.