What are risks from high-dose steroids?
In the short term, people worry about glycemic control, short-term psychiatric problems, hypertension and weight gain. Another problem is repeated exposure to high doses because patients with COPD are hospitalized regularly. Long-term risks can include immunosuppression and osteoporosis. Given your research, do physicians at Baystate use low-dose oral steroids? We don’t even measure it. We include oral steroids as a choice in our order set, but we’re no different from other hospitals: We have a hard enough time keeping up with publicly reported measures, throughput issues and Lean initiatives. There doesn’t tend to be enough capacity to study quality of care for conditions that aren’t publicly reported or part of pay for performance, unless it’s for research. What registry did you use for these studies? For both the antibiotic and the steroid analyses, we used Premier’s Perspective database, and the two populations were overlapping. About 85% of the patients included in the antibiotic
