Sex differences in survival of oxygen-dependent patients with chronic obstructive pulmonary disease

• Autor(a) principal: Machado, Maria Christina Lombardi Oliveira [UNIFESP]
• Data de Publicação: 2006
• Outros Autores: Krishnan, Jerry A., Buist, Sonia A., Bilderback, Andrew L., Fazolo, Guilherme P., Santarosa, Michelle G., Queiroga, Fernando, Vollmer, William M.
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Repositório Institucional da UNIFESP
• Texto Completo: http://repositorio.unifesp.br/handle/11600/29114; http://dx.doi.org/10.1164/rccm.200507-1057OC
• topic: sex differences; chronic obstructive pulmonary disease; hypoxemic; survival

Rationale: Chronic obstructive pulmonary disease (COPD) is a leading cause of death worldwide. the prevalence of COPID is rising among women and is approaching that of men, but it is not known if sex affects survival.Objectives: To measure the survival differences between men and women with oxygen-dependent COPD.Methods: We conducted a 7-yr prospective cohort study of 435 outpatients with COPD (184 women, 251 men) referred for long-term oxygen therapy (LTOT) at two respiratory clinics in São Paulo, Brazil. Baseline data were collected on enrollment into oxygen therapy, when patients were clinically stable.Measurements: We examined the effect of sex on survival using Kaplan-Meier survival curves, and then used Cox proportional hazards models to control for potential confounders.Main Results: in unadjusted analyses, we observed a nonsignificant trend toward increased mortality for women (hazard ratio, 1.28; 95% confidence interval, 0.98-1.68; p = 0.07). After accounting for potential confounders (age, pack-years smoked, Pa-O2, FEV1, body mass index), females were at a significantly higher risk of death (hazard ratio, 1.54, 95% confidence interval, 1.15-2.07; p = 0.004). Other independent predictors of death were lower Pa-O2 (P < 0.001) and lower body mass index (p < 0.05).Conclusions: Among patients with COPD on LTOT, women were more likely to die than men.