Male veterans with COPD experienced higher all-cause mortality (24.8% vs 14.6%) and hospital admissions compared to matched females, whereas females had higher emergency department utilization.
Cohort (n=2,548,805)
Sí
Does male sex compared to female sex affect all-cause mortality and healthcare utilization in veterans with COPD?
Women with COPD exhibit higher ED utilization but lower rates of hospitalization and all-cause mortality compared to men, suggesting they may seek healthcare earlier.
Tasa de eventos absoluta: 24.8% vs 14.6%
Abstract Rationale Sex-related differences may influence the clinical course and healthcare utilization patterns of patients with COPD. Understanding these differences is essential for improving disease management and outcomes.The aim of this study was to investigate the differences in all-cause mortality and healthcare utilization based on sex within a real-world cohort of veterans with COPD. Methods We designed a retrospective national study of veterans diagnosed with COPD between October 1999 and March 2025. We included veterans with any documentation of COPD diagnosis and at least two primary care physician visits in the prior 36 months. We stratified the analysis based on smoking status: current, former, and never smokers. Our primary outcomes were all-cause mortality, any hospitalization, and any emergency department (ED) visits. We used propensity-scored matching of one-to-one male versus female based on age, race, ethnicity, and 31 comorbidities from the Exhauster database. We reported the odds ratio and 95% confidence intervals (OR, 95%CI) for the outcomes using the female group as the reference. Results We identified 2,548,805 (female, 6%; age, 66.6±13.2 years; White, 71.9%; BMI, 29.2±6.7; death, 46.7%) with computable COPD phenotype. We matched 121,125 (current smoker, 45,599; former smoker, 29,704; never smoker, 48,822) females with 103,825 males (current smoker, 37,825; former smoker, 32,341; never smoker, 33,070). All-cause mortality was 19.3% with women dying at a lower rate (14.6%) compared to men (24.8%). Regardless of smoking status, although overall and COPD-related ED utilization were significantly higher in women, rates of COPD-related and all-cause hospital admissions and all-cause mortality were lower compared to men (Table 1). Conclusion All-cause mortality and hospitalization compared to ED healthcare utilization showed divergent patterns when comparing matched cohorts of females and males with COPD. Women with COPD may seek health care earlier than their male counterparts. Further investigation is needed to better define this divergence. This abstract is funded by: Supported by National Heart, Lung, and Blood Institute K25 funding (1K25HL152006-01 to J.R.); the Airborne Hazards and Burn Pits Center of Excellence (award FY2024-002 to J.R.); the Center for Innovations in Quality, Effectiveness, and Safety (CIN 13-413), Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas; and by Sanofi and Regeneron (award 92202 to A.S. & J.R.). The opinions expressed are those of the authors and not necessarily those of the Department of Veterans Affairs, the U.S. government, Baylor College of Medicine, or the industrial funding partners, i.e. Sanofi and Regeneron.
Razjouyan et al. (Fri,) conducted a cohort in Chronic Obstructive Pulmonary Disease (COPD) (n=2,548,805). Male sex vs. Female sex was evaluated on All-cause mortality. Male veterans with COPD experienced higher all-cause mortality (24.8% vs 14.6%) and hospital admissions compared to matched females, whereas females had higher emergency department utilization.
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