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Sex differences in mortality in patients with COPD

¹ Clínica Universitaria de Navarra, Pamplona, ² Hospital Universitario Nuestra Señora de la Candelaria, Tenerife, and ⁶ Hospital Miguel Servet, Zaragoza, Spain, ³ Bay Pines Veterans Affairs Health Care System, Bay Pines, FL, and ⁷ Caritas St Elizabeth's Medical Center, Tufts University, Boston, MA, USA, ⁴ Universidad de la República, Montevideo, Uruguay, ⁵ Departamento de Enfermedades Respiratorias, Pontificia Universidad Católica de Chile, Santiago, Chile, ⁸ Hospital Universitario de Caracas, Caracas, Venezuela, ⁹ Both authors contributed equally to this manuscript.

CORRESPONDENCE: J. P. de Torres, Pulmonary Dept, Clínica Universitaria de Navarra, Av. Pío XII 36, Pamplona, 31008, Spain. Fax: 34 948296500. E-mail: jupa65{at}hotmail.com

Keywords: BODE (body mass index, airflow obstruction, dyspnoea, exercise capacity) index, chronic obstructive pulmonary disease, mortality, sex

Received: June 25, 2008
Accepted October 14, 2008

Little is known about survival and clinical prognostic factors in females with chronic obstructive pulmonary disease (COPD). The aim of the present study was to determine the survival difference between males and females with COPD and to compare the value of the different prognostic factors for the disease.

In total, 265 females and 272 males with COPD matched at baseline by BODE (body mass index, airflow obstruction, dyspnoea, exercise capacity) and American Thoracic Society/European Respiratory Society/Global Initiative of Chronic Obstructive Lung Disease criteria were prospectively followed. Demographics, lung function, St George’s Respiratory Questionnaire, BODE index, the components of the BODE index and comorbidity were determined. Survival was documented and sex differences were determined using Kaplan–Meier analysis. The strength of the association of the studied variables with mortality was determined using multivariate and receiver operating curves analysis.

All-cause (40 versus 18%) and respiratory mortality (24 versus 10%) were higher in males than females. Multivariate analysis identified the BODE index in females and the BODE index and Charlson comorbidity score in males as the best predictors of mortality. The area under the curve of the BODE index was a better predictor of mortality than the forced expiratory volume in one second for both sexes.

At similar chronic obstructive pulmonary disease severity by BODE index and forced expiratory volume in one second, females have significantly better survival than males. For both sexes the BODE index is a better predictor of survival than the forced expiratory volume in one second.

This article has been cited by other articles:

				J. P. de Torres, C. Casanova, and B. R. Celli Sex, forced expiratory volume in 1 s decline, body weight change and C-reactive protein in COPD patients Eur. Respir. J., September 1, 2009; 34(3): 776 - 776. [Full Text] [PDF]

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				T. Lahm Sex differences in COPD Eur. Respir. J., July 1, 2009; 34(1): 288 - 289. [Full Text] [PDF]

				J. P. de Torres, C. Casanova, and B. R. Celli From the authors: Eur. Respir. J., July 1, 2009; 34(1): 289 - 289. [Full Text] [PDF]