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Abstract：
Introduction Chronic obstructive pulmonary disease (COPD) affects millions in China and imposes a considerable economic burden on hospitalized patients who experience exacerbations. Nebulized short-acting beta-2 agonists (SABA) are recommended as initial therapy for exacerbation patients, but the optimal SABA remains uncertain. This study aimed to evaluate the impact of different SABAs, such as albuterol and levalbuterol, on the length of stay (LOS) and direct medical costs among hospitalized patients diagnosed with COPD. Methods This retrospective cohort study uses linked hospital administrative data from three hospitals in Chongqing. Patients with COPD, aged 40 years and older, who had been continuously treated with nebulized albuterol or levalbuterol during hospitalization, were eligible for the study. Patients were matched 1:1 by sex, age, and severity according to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) grades 1-4. Patients were grouped according to the different SABA treatments they received. Demographic, economic, and clinical data were retrieved. LOS and direct healthcare costs were assessed. Results A total of 158 COPD patients were included, with 79 in each treatment group. Patients treated with levalbuterol had a significantly shorter median LOS (7.0 days vs. 8.0 days, P=0.003) and fewer direct healthcare median costs (total cost: ¥8,868.3 vs. ¥10,290.7, P=0.014; COPD-related western medicine fees: ¥383.8 vs. ¥505.3). Patients aged 60 or older were more likely to experience longer LOS and higher direct costs. Conclusion This retrospective cohort analysis supports that albuterol was associated with longer LOS and higher costs than levalbuterol.
摘要：
背景技术慢性阻塞性肺疾病(COPD)在中国影响数百万人,并且对经历恶化的住院患者施加相当大的经济负担。雾化吸入短效β-2激动剂（SABA）被推荐作为急性加重患者的初始治疗，但最优SABA仍不确定。本研究旨在评估不同SABA的影响，如沙丁胺醇和左沙丁胺醇，诊断为COPD的住院患者的住院时间（LOS）和直接医疗费用。方法本回顾性队列研究使用来自重庆市三家医院的关联医院管理数据。COPD患者,40岁及以上，在住院期间连续接受沙丁胺醇或左伐特罗雾化治疗的患者，有资格参加这项研究。患者按性别1：1匹配，年龄,和严重程度根据全球慢性阻塞性肺疾病倡议（GOLD）1-4级。根据他们接受的不同SABA治疗对患者进行分组。人口统计,经济,并检索临床资料。评估了LOS和直接医疗费用。结果共纳入158例COPD患者,各治疗组79。用利伐特罗治疗的患者中位LOS明显较短（7.0天与8.0天,P=0.003）和更少的直接医疗保健中位数成本（总成本：8,868.3日元与¥10,290.7，P=0.014；COPD相关西药费用：¥383.8vs.¥505.3)。60岁或以上的患者更有可能经历更长的LOS和更高的直接成本。结论本回顾性队列分析支持沙丁胺醇与左旋沙丁胺醇相比具有更长的LOS和更高的成本。
