Pharmacological treatment of acute exacerbations of chronic obstructive pulmonary disease at a Vietnamese secondary-level hospital: A retrospective study

Context: Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality worldwide, particularly during acute exacerbations requiring hospitalization. Aims: To assess the efficacy and rationality of pharmacological interventions administered to patients with acute exacerbations of COPD at a secondary-level hospital in Vietnam. Methods: A retrospective review was conducted on 100 hospitalized patients with confirmed COPD exacerbations. Data on bronchodilators, corticosteroids, antibiotics, and expectorants were analyzed. Treatment outcomes were assessed based on post-treatment FEV1 improvement, treatment duration, and discharge status, according to GOLD guidelines. Associations between treatment effectiveness and demographic or clinical variables were examined using Chi-square and multivariate logistic regression analyses. Results: Most patients were categorized as GOLD 2 (45%) or GOLD 3 (50%). A total of 95% responded positively to treatment, whereas failure was observed in patients with GOLD 3 (3%) and GOLD 4 (2%). ICS/LABA therapy demonstrated a 46.88% response rate. Rational prescribing practices were recorded in 82 cases for corticosteroids and 80 for antibiotics. Smoking behaviors and comorbidities were significantly associated with treatment outcomes (p<0.05). The average hospital stay was 10.14 ± 3.05 days. Conclusions: Pharmacological treatment for COPD exacerbations was generally effective and aligned with established guidelines. Smoking history and comorbid conditions influenced therapeutic outcomes, underscoring the need for individualized treatment strategies and antibiotic stewardship.