Smoking increased antibiotics and corticosteroids use and the risk of 1-year readmission in patients hospitalized with AECOPD: a retrospective cohort study

The impact of smoking history on medication use and readmission risk in acute exacerbation of chronic obstructive pulmonary disease (AECOPD) is not well understood. This study aimed to investigate the association between smoking and the use of antibiotics and corticosteroids, as well as the risk of AECOPD readmission. In this retrospective cohort study, we included 4,336 AECOPD inpatients with a median age of 72 (IQR: 64−79) years, among whom 78.4% were male. Patients were categorized into three groups: never smokers, ever smokers with < 40 pack-years, and ever smokers with ≥ 40 pack-years. Logistic regression was used to assess the association of smoking with antibiotic use, corticosteroid use, and AECOPD readmission. Ever smoking was associated with increased risk of antibiotic use, with an OR (95% CI) of 1.84 (1.32−2.57) for the < 40 pack-year group and 1.80 (1.29−2.53) for the ≥ 40 pack-year group. Similarly, smoking was associated with increased corticosteroid use, with an OR (95% CI) of 1.41 (1.17−1.71) for the < 40 pack-year group and 1.46 (1.20−1.78) for the ≥ 40 pack-year group. The 1-year risk of AECOPD readmission increased with higher smoking pack-years. Smoking history is a significant predictor of medication use and readmission risk, warranting further investigation into targeted interventions for smoking cessation in AECOPD patients.