Impact of Corticosteroid Dosing and Glucose Levels on Readmission Rates in Chronic Obstructive Pulmonary Disease Exacerbation Patients: A Study from Tertiary Care Center

Background: Chronic obstructive pulmonary disease (COPD) exacerbations often require hospitalization, and corticosteroids are commonly used for treatment. The impact of corticosteroid dosing and glucose levels on patient outcomes, particularly readmission rates, remains unclear. Aims and Objectives: This study aims to examine the impact of corticosteroid dosing and blood glucose levels on readmission rates in hospitalized COPD patients. The specific objectives include assessing the association between corticosteroid dosing adherence, glucose levels, and readmission rates within 30 and 90 days post-discharge. Materials and Methods: A retrospective analysis was conducted on 200 hospitalized COPD patients with exacerbations. Data collected included patient demographics, corticosteroid dosing, blood glucose levels, and discharge plans. The study evaluated readmission rates within 30 days and between 31 and 90 days post-discharge, comparing these rates against corticosteroid dosing adherence and glucose levels during hospitalization. Results: No significant association was found between adherence to recommended corticosteroid dosing and readmission rates within 30 days or between 31 and 90 days post-discharge. Average glucose levels during hospitalization did not affect readmission rates. Patients discharged to home with home health services or post-hospital facilities had higher 30-day readmission rates compared to those discharged home without additional care. Subgroup analysis revealed no significant trends in readmission rates among patients with prior diabetes diagnoses. Conclusion: The study indicates that adherence to recommended corticosteroid dosing and average glucose levels during hospitalization do not significantly affect readmission rates for COPD exacerbations. However, discharge plans involving home health services or post-hospital facilities are associated with higher 30-day readmission rates. While higher corticosteroid doses are not advocated, clinicians should be cautious of hyperglycemia risks, particularly in diabetic patients. The study’s limitations include its retrospective design and variability in steroid administration, suggesting a need for further investigation into in-hospital management strategies for COPD exacerbations and their impact on post-discharge outcomes.