TY - JOUR
T1 - Sex differences between women and men with COPD: A new analysis of the 3CIA study
AU - Alonso Pérez, Tamara
AU - García Castillo, Elena
AU - Ancochea, Julio
AU - Pastor-Sanz, Teresa María
AU - Almagro, Pere
AU - Martínez-Camblor, Pablo
AU - Miravitlles, Marc
AU - Rodriguez-Carballeira, Monica
AU - Navarro, Annie
AU - Lamprecht, Bernd
AU - Ramírez-García Luna, Ana S.
AU - Kaiser, Bernhard
AU - Alfageme, Inmaculada
AU - Casanova, Ciro
AU - Esteban, Cristobal
AU - Soler-Cataluña, Juan J.
AU - de-Torres, Juan P
AU - Celli, Bartolome R
AU - Marin, Jose M
AU - Lopez-Campos, Jose Luis
AU - Ter Riet, Gerben
AU - Sobradillo, Patricia
AU - Lange, Peter
AU - Garcia-Aymerich, Judith
AU - Antó,, Josep Maria
AU - Turner, Alice
AU - Han, MeiLan K
AU - Langhammer, Arnulf
AU - Sternberg, Alice
AU - Leivseth, Linda
AU - Bakke, Per
PY - 2020/8/25
Y1 - 2020/8/25
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 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.
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 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.
UR - https://www.sciencedirect.com/science/article/pii/S0954611120302456?dgcid=coauthor
M3 - Article
SN - 0954-6111
JO - Respiratory Medicine
JF - Respiratory Medicine
ER -