Background: Pneumonia is one of the most common conditions seen in hospitalized patients. While utilization of inhaled bronchodilators would be a consideration in the treatment of patients with exacerbations of underlying lung disease (ULD; i.e. asthma, COPD), their role in the absence of such underlying pathologies is not well defined. There is very little information about the routine use of inhaled bronchodilators when treating pneumonia in hospitalized patients without ULD. Comparison data is needed to determine if inhaled bronchodilators have any role in the treatment of pneumonia in this patient population. In this study we sought to identify if inhaled bronchodilator use in patients hospitalized for pneumonia without known ULD was associated with improved outcomes.
Methods: In this retrospective cohort study we analyzed data from patients hospitalized for pneumonia without known ULD within HCA Healthcare’s hospital system (152 hospitals across 20 states) between January 1 and December 31 of 2019. The primary outcomes were hospital length of stay, ICU admission, and in-hospital mortality.
Results: A total of 1593 patients were analyzed; 32.89% received inhaled bronchodilators at least once within 24 hours of admission. Hospital length of stay was 3.66 days shorter in patients who received inhaled bronchodilators (p<0.0001). Patients who did not receive inhaled bronchodilators were more likely to experience ICU admission (p=0.0244; OR 1.279; 95% CI 1.032-1.585). There was no statistical difference in in-hospital mortality between patients who received inhaled bronchodilators and those who did not.
Conclusions: In a multicenter, retrospective study of patients hospitalized for pneumonia without known ULD, inhaled bronchodilators were identified as a likely beneficial therapy. Hospital length of stay and ICU admission rates were significantly lower in patients who were treated with inhaled bronchodilators at least once within 24 hours of admission.
