Trends in COPD Hospitalization and In-Hospital Deaths in the United States by Sex: 2005-2014

Goel, Khushboo; Bailey, Mary L.; Borgstrom, Mark; Parthasarathy, Sairam; Berry, Cristine E.; Bime, Christian

doi:10.1513/annalsats.201807-488rl

Cited by 8 publications

(8 citation statements)

References 3 publications

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“…ICU admission rate and need for mechanical ventilation (invasive or noninvasive) were similar between women and men (Table 3). Median length of stay was shorter in women (2 [interquartile range, 1-4] vs. 3 d [1][2][3][4][5]; P = 0.04). Nearly all Veterans were discharged home (97% in women and 96% in men; P = 0.10).…”

Section: Resultsmentioning

confidence: 98%

“…In 2011, the estimated age-adjusted prevalence of COPD was 7.3% in women compared with 5.7% in men (1). Furthermore, whereas COPD mortality in men has declined over the past several decades, COPD mortality in women has increased by 107% between 1980 and 2014 (1,4), and women account for more COPD hospitalizations and in-hospital deaths than men (5). As disease burden in women has risen, sex differences in the pathophysiology, presentation, diagnosis, and treatment of COPD have been recognized (3,6).…”

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confidence: 99%

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Sex Differences in Veterans Admitted to the Hospital for Chronic Obstructive Pulmonary Disease Exacerbation

Bade

DeRycke

Ramsey³

et al. 2019

Annals ATS

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Rationale: As chronic obstructive pulmonary disease (COPD) prevalence in women has outpaced that in men, COPD-related hospitalization and mortality are now higher in women. Presentation, evaluation, and treatment of COPD differ between women and men. Despite higher smoking rates in Veterans, little work has characterized differences in Veterans with COPD by sex.Objectives: To determine risk factors for 30-day readmission among Veterans hospitalized for COPD exacerbations and how they differed by sex.Methods: We performed a retrospective observational analysis of Veterans receiving primary care in Veterans Health Affairs facilities. We included Veterans Administration-based hospitalizations for Veterans with a COPD exacerbation (identified by International Classification of Disease, Ninth Revision codes) who survived to discharge between fiscal years 2012 and 2015. Primary outcome was 30-day readmission. Predictors ascertained before hospitalization included smoking status (current, former, never), pulmonary function testing, pulmonary medication prescriptions, and medical and psychiatric comorbidities (identified by International Classification of Disease, ninth revision codes). We created combined and sex-stratified multivariate logistic regression models to identify associations with 30-day readmission.Results: Our sample included 48,888 Veterans (4% women). Compared with men, women Veterans were younger, more likely to be nonwhite, and differed in smoking status. Women were more likely to have asthma, drug use, and several psychiatric comorbidities. Before hospitalization, women were less likely to have pulmonary function testing (76% vs. 78%; P = 0.01) or be treated with antimuscarinic (43% vs. 48%) or combined long-acting bronchodilator/inhaled corticosteroid (61% vs. 64%) inhalers. Women were more likely to receive nicotine-replacement therapy (all P , 0.01). Women had shorter length of stay (median days, 2 vs. 3; P = 0.04) and lower 30-day readmission rate (20% vs. 22%; P = 0.01). In adjusted models including both sexes, age, antimuscarinic use, comorbidities, and diagnosis of drug or alcohol use were associated with readmission; there was no association with sex and readmission risk. In models stratified by sex, associations were similar between women and men.Conclusions: This study suggests differences between women and men hospitalized for COPD regarding presentation, evaluation, and management. Readmission is strongly influenced by comorbidities, suggesting individualized and comprehensive case management may reduce readmission risk for women and men with COPD.

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Section: Resultsmentioning

confidence: 98%

mentioning

confidence: 99%

Sex Differences in Veterans Admitted to the Hospital for Chronic Obstructive Pulmonary Disease Exacerbation

Bade

DeRycke

Ramsey³

et al. 2019

Annals ATS

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“…Trends in COPD hospitalisations identified that within the USA the number of deaths in hospitals related to COPD has declined [8]. However, despite this overall decline, woman account for a higher proportion of hospitalisations and inpatient deaths.…”

Section: Women With Copdmentioning

confidence: 99%

Women with COPD

McIvor

Saraiva

Denning

et al. 2020

Breathe

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“…61,71 Furthermore, women have a greater risk of exacerbations (after adjusting for smoking) 24,25 and, COPD-related hospitalization and death compared with men. 75,76 Other factors, such as comorbidities and adherence to treatment may also differ between men and women and should be considered. 72,74 A goal of this literature review was to investigate biological factors potentially underlying these differences.…”

Section: Discussionmentioning

confidence: 99%

<p>Chronic Obstructive Pulmonary Disease in Women: A Biologically Focused Review with a Systematic Search Strategy</p>

Han

2020

COPD

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Purpose: Evidence suggests that chronic obstructive pulmonary disease (COPD) symptoms and progression may differ between men and women. However, limited information is currently available on the pathophysiological and biological factors that may underlie these sex-related differences. The objective of this review is to systematically evaluate reports of potential sexrelated differences, including genetic, pathophysiological, structural, and other biological factors, that may influence COPD development, manifestation, and progression in women. Patients and Methods: A PubMed literature search was conducted from inception until January 2020. Original reports of genetic, hormonal, and physiological differences, and biological influences that could contribute to COPD development, manifestation, and progression in women were included. Results: Overall, 491 articles were screened; 29 articles met the inclusion criteria. Results from this analysis demonstrated between-sex differences in inflammatory, immune, genetic, structural, and physiological factors in patients with COPD. Conclusion: Various biological differences are observed between men and women with COPD including differences in inflammatory and metabolic pathways related to obesity and fat distribution, immune cell function and autophagy, extent and distribution of emphysema and airway wall remodeling. An enhanced understanding of these differences has the potential to broaden our understanding of how COPD develops and progresses, thereby providing an opportunity to ultimately improve diagnosis, treatment, and monitoring of COPD in both men and women.

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Trends in COPD Hospitalization and In-Hospital Deaths in the United States by Sex: 2005-2014

Cited by 8 publications

References 3 publications

Sex Differences in Veterans Admitted to the Hospital for Chronic Obstructive Pulmonary Disease Exacerbation

Sex Differences in Veterans Admitted to the Hospital for Chronic Obstructive Pulmonary Disease Exacerbation

Women with COPD

<p>Chronic Obstructive Pulmonary Disease in Women: A Biologically Focused Review with a Systematic Search Strategy</p>

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