Differences in Pulmonary and Extra-Pulmonary Traits between Women and Men with Chronic Obstructive Pulmonary Disease

Abstract

Background: Evidence suggests sex-related differences in chronic obstructive pulmonary disease (COPD). Whether these differences are reflected in the prevalence of treatable traits remains unknown. Methods: Two samples of patients referred to secondary (n = 530) or tertiary care (n = 2012) were analyzed. Men and women were matched for age, forced expiratory volume in 1 s and body mass index. Sex-related differences were tested using t-tests, Mann-Whitney U, or chi-square tests. Results: Frequent exacerbations (30.5 vs. 19.7%), high cardiovascular risk (88.1 vs. 66.2%) and activity-related severe dyspnea (50.9% vs. 34.8%) were more prevalent in women in secondary care (p < 0.05). Severe hyperinflation (43.0 vs. 25.4%), limited diffusing capacity (79.6 vs. 70.1%), impaired mobility (44.0 vs. 28.7%), frequent exacerbations (66.8 vs. 57.4%), frequent hospitalizations (47.5 vs. 41.6%), severe activity-related dyspnea (89.1 vs. 85.0%), symptoms of anxiety (56.3 vs. 42.0%) and depression (50.3 vs. 44.8%), and poor health status (79.9 vs. 71.0%) were more prevalent in women in tertiary care (p < 0.05). Severe inspiratory muscle weakness (14.6% vs. 8.2%) and impaired exercise capacity (69.1% vs. 59.6%) were more prevalent among men (p < 0.05) in tertiary care. Conclusions: Sex-related differences were found, with most traits more prevalent and severe among women. Care providers should be aware of these differences to adjust treatment.

Pulmonary rehabilitation after severe exacerbation of COPD: a nationwide population study

“…Moreover, Souto-Miranda et al . [ 29 ] showed that women suffer more activity-related dyspnea, severe hyperinflation, frequent exacerbation and hospitalization, which could explain why women were more frequently referred for PR.…”

“…Compared to men, women with COPD have a lower quality of life, face a more rapid decline in lung function [27] and more frequent anxiety and depression, which could lead to higher healthcare consumption [28]. Moreover, Souto-Miranda et al [29] showed that women suffer more activity-related dyspnea, severe hyperinflation, frequent exacerbation and hospitalization, which could explain why women were more frequently referred for PR. We found that patients who were older, who required more oxygen or NIV or who had more comorbidities were significantly more likely to receive PR.…”

Association of Red Cell Index and Adverse Hospitalization Outcomes in Chronic Obstructive Pulmonary Disease Patients with Acute Exacerbation: A Retrospective Cohort Study

“…Researchers have previously found that male and female patients have significant differences regarding disease severity, prognosis, and comorbidities. 32 , 33 COPD has traditionally been seen as a disease of older men, but in recent years its prevalence among female patients has steadily increased. Future studies are needed to focus more on women with COPD.…”

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“…The study of S outo- M iranda et al . [ 33 ] showed that sex-related differences exist in treatable traits among patients with COPD. Most traits were more prevalent in women than men in patients referred to secondary and tertiary care, with differences being more extensive in tertiary care.…”