Purpose: Previous studies suggest that the clinical presentation of chronic obstructive pulmonary disease (COPD) is different between men and women. The aim of this study was to investigate sex-related differences and survival among COPD patients. Patients and Methods: Multicentric prospective real-life cohort. COPD patients (post-bronchodilator FEV 1 /FVC < 0.7) of any stages of airway obstruction recruited since January 2014 by pulmonologists. Stratified logistic regression models assessed to identify the determinants of dyspnea, exacerbations, ABE classification and all-cause mortality by sex. Kaplan–Meier curves and Cox proportional-hazards models were also performed. Results: A total of 3265 patients included, with 36.7% women. Women had an increased risk of ≥ 2 exacerbations (aOR=1.79; 95% CI1.46– 2.19), mMRC grade 1 (aOR=1.46; 95% CI1.14– 1.89) and grade 2 (aOR=1.41; 95% CI1.07– 1.87) and a higher risk of severity E of the ABE classification (aOR=1.56; 95% CI1.27– 1.93). In stratified models, the determinants of these outcomes were different. Men had a lower survival rate at GOLD airway obstruction I–II (Log-rank: p< 0.0001) and III–IV (Log-rank: p< 0.0001) and a higher risk of mortality (HR=1.62; 95% CI1.40– 1.87). Common factors characterizing mortality were: age, BMI < 18.5, mMRC ≥ 2, airway obstruction, diabetes and lung cancer. Additional factors related to mortality in men were asthma, left heart failure and tobacco-related cancers. Conclusion: COPD is more severe in women however men have a higher risk of mortality. Clinical features and mortality in men and women with COPD are different in our cohort. Further studies are needed to elucidate sex-related differences among COPD patients. Keywords: COPD, women, exacerbations, mortality
Jestin-Guyon et al. (Sun,) studied this question.