| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
1 Institute for Clinical Evaluative Sciences (ICES), 2 Dept of Medicine, Sunnybrook And Women's College Health Science Center, University of Toronto, Toronto, Ontario, 3 Dept of Medicine, University of Alberta, Edmonton, Alberta, Canada
CORRESPONDENCE: D.D. Sin, 2E4.29 Walter C. Mackenzie Centre, University of Alberta, Edmonton, AB, Canada. Fax: 1 7804076384
Keywords: asthma, hospitalization, inhaled corticosteroids, mortality
Received: January 27, 2000
Accepted June 16, 2000
This work is supported in part by ICES, which is funded by the Ontario Ministry of Health. Dr. Sin was supported by a fellowship from the Alberta Heritage Foundation for Medical Research at the time of this work. Dr. Tu is supported by a Medical Research Council of Canada Scholarship Award.
Elderly patients with asthma have relatively high rates of hospitalization and mortality. Although inhaled corticosteroids have been shown to improve outcomes among younger patients with asthma, their usefulness in elderly patients has not been established. Therefore, a population-based study of patients 65 yrs of age or older, who have been hospitalized at least once with asthma in Ontario, Canada was conducted to determine the impact of inhaled corticosteroids on rehospitalization for asthma and all-cause mortality rates.
Data from the Canadian Institute of Health Information was used to capture all patients 65 yrs of age and older who were hospitalized at least once, with the most responsible diagnosis of asthma in Ontario, Canada between fiscal year 1992 and 1996. This database was then linked with drug claims, physician billing and mortality databases.
In total, 6,254 consecutive elderly patients with asthma were identified. Sixty percent of these patients were given at least one prescription for inhaled corticosteroids within 90 days postdischarge from their index hospitalization for asthma. Users of inhaled corticosteroids postdischarge were 29% (95% confidence interval (CI) 20%–38%) less likely to be readmitted to hospital for asthma and 39% (95% CI, 20%–53%) less likely to experience all-cause mortality compared to those who did not receive these drugs postdischarge over a one year follow-up period.
These findings suggest that inhaled corticosteroids are beneficial in reducing the risk for rehospitalization and all-cause mortality in elderly patients with asthma who have recently been hospitalized for their disease.
This article has been cited by other articles:
|
|
 |
|
  Y. R. B. M. van Gestel, S. E. Hoeks, D. D. Sin, G. M. J. M. Welten, O. Schouten, H. J. Witteveen, C. Simsek, H. Stam, F. W. Mertens, J. J. Bax, et al. Impact of Cardioselective {beta}-Blockers on Mortality in Patients with Chronic Obstructive Pulmonary Disease and Atherosclerosis Am. J. Respir. Crit. Care Med., October 1, 2008; 178(7): 695 - 700. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. A. Camargo Jr, R. G. Barr, R. Chen, and F. E. Speizer Prospective Study of Inhaled Corticosteroid Use, Cardiovascular Mortality, and All-Cause Mortality in Asthmatic Women Chest, September 1, 2008; 134(3): 546 - 551. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 G. Gartlehner, R. A. Hansen, S. S. Carson, and K. N. Lohr Efficacy and Safety of Inhaled Corticosteroids in Patients With COPD: A Systematic Review and Meta-Analysis of Health Outcomes Ann. Fam. Med, May 1, 2006; 4(3): 253 - 262. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 Z. Zhou, E. Rahme, M. Abrahamowicz, and L. Pilote Survival Bias Associated with Time-to-Treatment Initiation in Drug Effectiveness Evaluation: A Comparison of Methods Am. J. Epidemiol., November 15, 2005; 162(10): 1016 - 1023. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. D. Sin, J. Man, H. Sharpe, W. Q. Gan, and S. F. P. Man Pharmacological Management to Reduce Exacerbations in Adults With Asthma: A Systematic Review and Meta-analysis JAMA, July 21, 2004; 292(3): 367 - 376. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
N. A. Hanania, P. Darken, D. Horstman, C. Reisner, B. Lee, S. Davis, and T. Shah The Efficacy and Safety of Fluticasone Propionate (250 {micro}g)/Salmeterol (50 {micro}g) Combined in the Diskus Inhaler for the Treatment of COPD Chest, September 1, 2003; 124(3): 834 - 843. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Suissa Effectiveness of Inhaled Corticosteroids in Chronic Obstructive Pulmonary Disease: Immortal Time Bias in Observational Studies Am. J. Respir. Crit. Care Med., July 1, 2003; 168(1): 49 - 53. [Abstract] [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
