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Sex differences in mortality in patients with COPD.
J P de Torres1, C G Cote, M V López
1Pulmonary Department, Clínica Universitaria de Navarra, Av. Pío XII 36, Pamplona, 31008, Spain. jupa65@hotmail.com
The European Respiratory Journal
|December 3, 2008
Summary
Males with chronic obstructive pulmonary disease (COPD) face higher mortality than females. The BODE index effectively predicts survival in both sexes, outperforming lung function tests for COPD patients.
Area of Science:
- Pulmonary Medicine
- Clinical Prognostics
- Epidemiology
Background:
- Limited data exists on survival and prognostic factors for females with chronic obstructive pulmonary disease (COPD).
- Understanding sex-based differences in COPD outcomes is crucial for personalized medicine.
Purpose of the Study:
- To compare survival rates between males and females diagnosed with COPD.
- To evaluate and compare the effectiveness of various clinical prognostic factors in predicting mortality in COPD patients of both sexes.
Main Methods:
- Prospective follow-up of 265 females and 272 males with COPD, matched by BODE index and ATS/ERS/GOLD criteria.
- Data collection included demographics, lung function, quality of life (St George's Respiratory Questionnaire), BODE index components, and comorbidities.
- Survival analysis utilized Kaplan-Meier, multivariate analysis, and receiver operating characteristic (ROC) curves to assess prognostic factors.
Main Results:
- All-cause and respiratory mortality rates were significantly higher in males compared to females.
- The BODE index was identified as the best mortality predictor in females, while both the BODE index and Charlson comorbidity score were key predictors in males.
- The BODE index demonstrated superior predictive value for mortality compared to forced expiratory volume in one second (FEV1) in both sexes.
Conclusions:
- Females with COPD exhibit significantly better survival rates than males when matched for disease severity using the BODE index and FEV1.
- The BODE index is a more robust predictor of survival in COPD patients than FEV1, irrespective of sex.
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