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Title

Effects of Pre-Hospital Dexamethasone Administration on Outcomes of Patients with COPD and Asthma Exacerbation, a Cross-Sectional Study

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Abstract

 Introduction: chronic obstructive Pulmonary disease (COPD) and Asthma exacerbation are two common emergency situations. This study aimed to investigate the impact of pre-hospital Dexamethasone initiation on treatment outcomes of these patients. Methods: In this retrospective cross-sectional and comparative study, data fromthe emergency medical service (EMS) care report of patients with a final diagnosis of Asthma or COPD, coded with Thailand’, s emergency medical triage protocol, collected between January 1, 2021, and October 31, 2022, were used. Data on baseline characteristics, emergency department Length of stay (ED-LOS), and hospital admission rates were collected from electronic medical records and compared between cases with and without pre-hospital Dexamethasone administration by EMS. Results: 200 patients with COPD (n = 93) and Asthma (n = 107) exacerbation were enrolled. The Dexamethasone-treated group had a lower but statistically non-significant hospital admission rate (71. 0%versus 81. 0%, absolute difference: 10%, 95% confidence interval (CI): 21. 76, 1. 76,p = 0. 100). In patients with Asthma, the Dexamethasone-treated had lower median ED-LOS time (235 (IQR: 165. 5–, 349. 5) versus 322 (IQR: 238–, 404) minutes,p = 0. 003). Dexamethasone-treated Asthma patients had lower but statistically non-significant hospital admission rates (60. 4% versus 78. 0%, absolute difference: 17. 55%, 95% CI: 34. 96, 0. 14,p = 0. 510). In COPD patients the Dexamethasone-treated and untreated groups had non-significantly lower hospital admission rates (80. 8% versus 85. 40%, absolute difference: 4. 60%, 95% CI: 19. 82, 10. 63,p = 0. 561) and non-significantly lower ED-LOS (232 (IQR: 150 –,346) versus 296 (IQR: 212 –,330) minutes, absolute difference: 59 (130. 81, 12. 81),p = 0. 106). Conclusion: The Dexamethasone administration by EMS in pre-hospital setting for management of Asthma and COPD patients is beneficial in reducing the ED-LOS and need for hospital admission but its effects are not statistically significant, except regarding the ED-LOS of Asthma exacerbation cases.

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    APA: Copy

    Huabbangyang, Thongpitak, Silakoon, Agasak, Sangketchon, Chunlanee, Sukhuntee, Jareeda, Kumkong, Jukkit, Srithanayuchet, Tanut, Chamnanpol, Parinya, & Meechai, Theeraphat. (2023). Effects of Pre-Hospital Dexamethasone Administration on Outcomes of Patients with COPD and Asthma Exacerbation, a Cross-Sectional Study. ARCHIVES OF ACADEMIC EMERGENCY MEDICINE (EMERGENCY), 11(1), 0-0. SID. https://sid.ir/paper/1116045/en

    Vancouver: Copy

    Huabbangyang Thongpitak, Silakoon Agasak, Sangketchon Chunlanee, Sukhuntee Jareeda, Kumkong Jukkit, Srithanayuchet Tanut, Chamnanpol Parinya, Meechai Theeraphat. Effects of Pre-Hospital Dexamethasone Administration on Outcomes of Patients with COPD and Asthma Exacerbation, a Cross-Sectional Study. ARCHIVES OF ACADEMIC EMERGENCY MEDICINE (EMERGENCY)[Internet]. 2023;11(1):0-0. Available from: https://sid.ir/paper/1116045/en

    IEEE: Copy

    Thongpitak Huabbangyang, Agasak Silakoon, Chunlanee Sangketchon, Jareeda Sukhuntee, Jukkit Kumkong, Tanut Srithanayuchet, Parinya Chamnanpol, and Theeraphat Meechai, “Effects of Pre-Hospital Dexamethasone Administration on Outcomes of Patients with COPD and Asthma Exacerbation, a Cross-Sectional Study,” ARCHIVES OF ACADEMIC EMERGENCY MEDICINE (EMERGENCY), vol. 11, no. 1, pp. 0–0, 2023, [Online]. Available: https://sid.ir/paper/1116045/en

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