Students Research in Progress
Tuesday, October 15, 2024
08:30 AM–10:00 AM
Abstract
Introduction:
Corticosteroids (CS) are a guideline-recommended, fast-acting, and effective mainstay of treatment for acute asthma exacerbations. Clinicians often administer higher CS doses than the guideline-recommended 40–50 mg of prednisone, or the equivalent. High doses of CS can lead to acute hyperglycemia in patients with or without diabetes, as well as glucocorticoid-induced leukocytosis. Further evidence is needed to determine whether higher doses of CS are associated with more side effects than guideline-recommended doses.
Research Question or Hypothesis: Guideline-directed dosing of CS for the treatment of asthma exacerbations will be associated with a reduction in the incidence of hyperglycemia, hypoglycemia, leukocytosis, antibiotic initiation, length of stay, and readmission.
Study Design: A retrospective, exploratory, single-center, cohort study.
Methods: Adult patients admitted to an urban, academic health system between 03/2022 and 08/2024 with a diagnosis of asthma exacerbation will be screened and included. Patients with recent or chronic CS use or positive COVID test will be excluded. Subjects will be divided into two cohorts: those receiving guideline-directed CS dosing and those receiving higher doses. The primary outcome is the incidence of glucose > 180 mg/dL in patients who received the guideline recommended dose of CS versus those patients that received higher doses. Glucose measurements will be collected for 24 hours after the first dose of CS is given or until a second dose is given, whichever occurs sooner. Secondary outcomes include average glucose levels in the first 48 hours, incidence of hypoglycemia, insulin units administered, leukocytosis, initiation of antibiotics, length of stay, and 30-day readmission rates.
Data Analysis/Statistics: Assuming a variance of 25 mg/dL in glucose and a minimum difference between groups of 10 mg/dL, the study would require 100 subjects in each arm to attain a power of 80%. Statistical analyses of endpoints will be assessed using descriptive and inferential statistics using R software.
Results: N/A
Conclusion: N/A
Presenting Author
Connery Brennan MSUniversity of Illinois Chicago
Authors
Emily Hanners PharmD, BCPS
University of Illinois Chicago College of Pharmacy
Mathew Thambi PharmD, BCPS, MPH
University of Illinois at Chicago