Efficacy and economic evaluation of different doses of budesonide for preventing pulmonary complications after pulmonary lobectomy

He Jianrong; Wu Di; Xie Dashuai; Shi Ping; Niu Zhaofeng; Duan Jinju

doi:10.3760/j.issn.1673-4777.2024.01.008

Abstract：Objective To investigate the efficacy and economic efficacy of different doses of budesonide in preventing pulmonary complications(PPCs)after pulmonary lobectomy.Methods The data of 160 patients who underwent pulmonary lobectomy in Yuncheng Central Hospital,Shanxi Province from January 2021 to December 2022 were retrospectively analyzed.According to the different doses of budesonide suspension after surgery,patients were divided into high-dose group(daily dose＞4 mg,group H,62 cases)and low-dose group(daily dose≤4 mg,group L,98 cases).The basic information of patients was recorded.The incidence of PPCs,retention time of thoracic drainage tubes,duration of sputum weakness,postoperative length of stay,postoperative cost and usage of antibiotics,postoperative medical and drug costs,and postoperative drug proportion of the two groups were compared.Univariate and multivariate Logistic regression models were used to analyze the risk factors affecting PPCs.Results There were no statistically significant differences in the incidence of PPCs,retention time of thoracic drainage tubes,and postoperative length of stay between the two groups(all P＞0.05).The duration of sputum weakness in group H was shorter than that in group L[2(2,2)d vs 2(2,3)d](P＜0.05).For patients with pulmonary infection,there were no statistically significant differences in the treatment cost and cumulative defined daily dose of antibiotics between the two groups(all P＞0.05).There were no statistically significant differences in postoperative medical costs,drug costs and drug proportion between the two groups(all P＞0.05).The multivariate Logistic regression results showed that smoking history,poor health status,long surgical time,and triple medication plan of airway management combined with medication regimen were independent risk factors for PPCs(all P＜0.01).Conclusions High-dose budesonide has no significant advantage in preventing PPCs,and it is recommended to refer to the instructions for daily maximum dose of 4 mg.Quadruple interventions containing doxofylline significantly reduce the incidence of pulmonary complications and are recommended for airway management.