TY - JOUR
T1 - Sex differences between women and men with COPD
T2 - A new analysis of the 3CIA study
AU - Perez, Tamara Alonso
AU - Castillo, Elena García
AU - Ancochea, Julio
AU - Pastor Sanz, María Teresa
AU - Almagro, Pere
AU - Martínez-Camblor, Pablo
AU - Miravitlles, Marc
AU - Rodríguez-Carballeira, Mónica
AU - Navarro, Annie
AU - Lamprecht, Bernd
AU - Ramírez-García Luna, Ana S
AU - Kaiser, Bernhard
AU - Alfageme, Inmaculada
AU - Casanova, Ciro
AU - Esteban, Cristóbal
AU - Soler-Cataluña, Juan J
AU - De-Torres, Juan P
AU - Celli, Bartolomé R
AU - Marin, Jose M
AU - Lopez-Campos, Jose L
AU - Riet, Gerben Ter
AU - Sobradillo, Patricia
AU - Lange, Peter
AU - Garcia-Aymerich, Judith
AU - Anto, Josep M
AU - Turner, Alice M
AU - Han, MeiLan K
AU - Langhammer, Arnulf
AU - Sternberg, Alice
AU - Leivseth, Linda
AU - Bakke, Per
AU - Johannessen, Ane
AU - Oga, Toru
AU - Cosío, Borja
AU - Echazarreta, Andres
AU - Roche, Nicolas
AU - Burgel, Pierre-Régis
AU - Sin, Don D
AU - Puhan, Milo A
AU - Soriano, Joan B
N1 - Copyright © 2020 Elsevier Ltd. All rights reserved.
PY - 2020/9
Y1 - 2020/9
N2 - 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 FEV
1%, 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.
AB - 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 FEV
1%, 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.
KW - COPD
KW - Female
KW - Sex
KW - Survival
UR - http://www.scopus.com/inward/record.url?scp=85089814281&partnerID=8YFLogxK
U2 - 10.1016/j.rmed.2020.106105
DO - 10.1016/j.rmed.2020.106105
M3 - Journal article
C2 - 32858497
SN - 0954-6111
VL - 171
SP - 106105
JO - Respiratory medicine
JF - Respiratory medicine
M1 - 106105
ER -