Sex differences between women and men with COPD: A new analysis of the 3CIA study

Tamara Alonso Perez, Elena García Castillo, Julio Ancochea, María Teresa Pastor Sanz, Pere Almagro, Pablo Martínez-Camblor, Marc Miravitlles, Mónica Rodríguez-Carballeira, Annie Navarro, Bernd Lamprecht, Ana S. Ramírez-García Luna, Bernhard Kaiser, Inmaculada Alfageme, Ciro Casanova, Cristóbal Esteban, Juan J. Soler-Cataluña, Juan P. De-Torres, Bartolomé R. Celli, Jose M. Marin, Jose L. Lopez-CamposGerben Ter Riet, Patricia Sobradillo, Peter Lange, Judith Garcia-Aymerich, Josep M. Anto, Alice M. Turner, Mei Lan K. Han, Arnulf Langhammer, Alice Sternberg, Linda Leivseth, Per Bakke, Ane Johannessen, Toru Oga, Borja Cosío, Andres Echazarreta, Nicolas Roche, Pierre Régis Burgel, Don D. Sin, Milo A. Puhan, Joan B. Soriano

Research output: Contribution to journalArticlepeer-review

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.

Original languageEnglish (US)
Article number106105
JournalRespiratory Medicine
Volume171
DOIs
StatePublished - Sep 2020

Keywords

  • COPD
  • Female
  • Sex
  • Survival

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

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