Tamara Alonso Perez1, Elena García Castillo1, Julio Ancochea1, María Teresa Pastor Sanz1, Pere Almagro2, Pablo Martínez-Camblor3, Marc Miravitlles4, Mónica Rodríguez-Carballeira2, Annie Navarro2, Bernd Lamprecht5, Ana S Ramírez-García Luna6, Bernhard Kaiser7, Inmaculada Alfageme8, Ciro Casanova9, Cristóbal Esteban10, Juan J Soler-Cataluña11, Juan P De-Torres12, Bartolomé R Celli13, Jose M Marin14, Jose L Lopez-Campos15, Gerben Ter Riet16, Patricia Sobradillo17, Peter Lange18, Judith Garcia-Aymerich19, Josep M Anto19, Alice M Turner20, MeiLan K Han21, Arnulf Langhammer22, Alice Sternberg23, Linda Leivseth24, Per Bakke25, Ane Johannessen25, Toru Oga26, Borja Cosío27, Andres Echazarreta28, Nicolas Roche29, Pierre-Régis Burgel30, Don D Sin31, Milo A Puhan32, Joan B Soriano33. 1. Hospital Universitario de la Princesa, Madrid, Spain. 2. Hospital Mutua de Terrassa, Terrassa, Spain. 3. The Dartmouth Institute for Health Policy and Clinical Practice, Dartmouth, USA. 4. Hospital Vall d'Hebron, Barcelona, Spain. 5. Kepler Universitätsklinikum, Linz, Austria. 6. Hospital Lomas de San Luis, San Luis Potosí, Mexico. 7. Department of Health Economics, Upper Austrian Health Insurance, Linz, Austria. 8. Hospital de Valme, Sevilla, Spain. 9. Hospital de La Candelaria, Santa Cruz de Tenerife, Spain. 10. Hospital de Galdakao-Usansolo, Bilbao, Spain. 11. Hospital Arnau de Vilanova-Lliria, Valencia, Spain. 12. Kingston General Hospital Site, Ontario, Canada. 13. Brigham and Women's Hospital, Boston, USA. 14. Hospital Miguel Servet, Zaragoza, Spain. 15. Hospital Virgen del Rocío, Sevilla, Spain. 16. Academisch Medisch Centrum Universiteit van Amsterdam, Amsterdam, Netherlands. 17. Hospital de Cruces, Bilbao, Spain. 18. Hvidovre Hospital, Copenhagen, Denmark. 19. Instituto de Salud Global, Barcelona, Spain. 20. Institute of Applied Health Research, Birmingham, United Kingdom. 21. University of Michigan Health System, Michigan, USA. 22. Norwegian University of Science and Technology, Trondheim, Norway. 23. Johns Hopkins Bloomberg School of Public Health, Baltimore, USA. 24. Centre for Clinical Documentation and Evaluation (SKDE), Troms, Norway. 25. University of Bergen, Bergen, Norway. 26. Kyushu University, Fukuoka, Japan. 27. Hospital Son Espases, Palma de Mallorca, Spain. 28. Hospital San Juan de Dios de La Plata, La Plata, Argentina. 29. Hôpital Cochin (Hôpitaux Universitaires Paris Centre), Paris, France. 30. Université Paris Descartes, Paris, France. 31. University of British Columbia, Vancouver, Canada. 32. Institut für Epidemiologie, Biostatistik und Prävention, Zürich, Austria. 33. Hospital Universitario de la Princesa, Madrid, Spain. Electronic address: jbsoriano2@gmail.com.
Abstract
BACKGROUND: There is partial evidence that COPD is expressed differently in women than in men, namely on symptoms, pulmonary function, exacerbations, comorbidities or prognosis. There is a need to improve the characterization of COPD in females. METHODS: We obtained and pooled data of 17 139 patients from 22 COPD cohorts and analysed the clinical differences by sex, establishing the relationship between these characteristics in women and the prognosis and severity of the disease. Comparisons were established with standard statistics and survival analysis, including crude and multivariate Cox-regression analysis. RESULTS: Overall, 5355 (31.2%) women were compared with men with COPD. Women were younger, had lower pack-years, greater FEV1%, lower BMI and a greater number of exacerbations (all p < 0.05). On symptoms, women reported more dyspnea, equal cough but less expectoration (p < 0.001). There were no differences in the BODE index score in women (2.4) versus men (2.4) (p = 0.5), but the distribution of all BODE components was highly variable by sex within different thresholds of BODE. On prognosis, 5-year survival was higher in COPD females (86.9%) than in males (76.3%), p < 0.001, in all patients and within each of the specific comorbidities that we assessed. The crude and adjusted RR and 95% C.I. for death in males was 1.82 (1.69-1.96) and 1.73 (1.50-2.00), respectively. CONCLUSIONS: COPD in women has some characteristic traits expressed differently than compared to men, mainly with more dyspnea and COPD exacerbations and less phlegm, among others, although long-term survival appears better in female COPD patients.
BACKGROUND: There is partial evidence that COPD is expressed differently in women than in men, namely on symptoms, pulmonary function, exacerbations, comorbidities or prognosis. There is a need to improve the characterization of COPD in females. METHODS: We obtained and pooled data of 17 139 patients from 22 COPD cohorts and analysed the clinical differences by sex, establishing the relationship between these characteristics in women and the prognosis and severity of the disease. Comparisons were established with standard statistics and survival analysis, including crude and multivariate Cox-regression analysis. RESULTS: Overall, 5355 (31.2%) women were compared with men with COPD. Women were younger, had lower pack-years, greater FEV1%, lower BMI and a greater number of exacerbations (all p < 0.05). On symptoms, women reported more dyspnea, equal cough but less expectoration (p < 0.001). There were no differences in the BODE index score in women (2.4) versus men (2.4) (p = 0.5), but the distribution of all BODE components was highly variable by sex within different thresholds of BODE. On prognosis, 5-year survival was higher in COPD females (86.9%) than in males (76.3%), p < 0.001, in all patients and within each of the specific comorbidities that we assessed. The crude and adjusted RR and 95% C.I. for death in males was 1.82 (1.69-1.96) and 1.73 (1.50-2.00), respectively. CONCLUSIONS:COPD in women has some characteristic traits expressed differently than compared to men, mainly with more dyspnea and COPD exacerbations and less phlegm, among others, although long-term survival appears better in female COPDpatients.
Authors: Maura Alvarez Baumgartner; Chengchen Li; Thomas M Kuntz; Lina Nurhussien; Andrew J Synn; Wendy Y Sun; Jennifer E Kang; Peggy S Lai; Jeremy E Wilkinson; Mary B Rice Journal: Chronic Obstr Pulm Dis Date: 2022-07-29
Authors: Laura Carrasco Hernández; Candela Caballero Eraso; Borja Ruiz-Duque; María Abad Arranz; Eduardo Márquez Martín; Carmen Calero Acuña; Jose Luis Lopez-Campos Journal: J Clin Med Date: 2021-04-15 Impact factor: 4.241
Authors: Arzu Ulu; Jalene V Velazquez; Abigail Burr; Stefanie N Sveiven; Jun Yang; Carissa Bravo; Bruce D Hammock; Tara M Nordgren Journal: Front Pharmacol Date: 2022-01-13 Impact factor: 5.810