Clinical Features Of Women With COPD: Sex Differences In A Cross-Sectional Study In Spain (“The ESPIRAL-ES Study”)

Figures & data

Table 1 Characteristics Of 286 Women With COPD

Study Variables	Female Patients		Male Patients		P value
	Number	Descriptive Data	Number	Descriptive Data
Age, years, mean (SD) [95% CI]	279	63.4 (10.2) [66.2 to 64.6]	1298	67.4 (9.4) [66.9 to 67.9]	< 0.001
Body mass index, kg/m^2, mean (SD) [95% CI]	281	27.4 (5.2) [26.8 to 28.0]	1296	28 (4.6) [27.7 to 28.2]	0.072
Smoking status	285		1313		< 0.001
Current smoker		152 (53.3)		738 (56.2)
Ex-smoker		107 (37.5)		567 (43.2)
Never-smoker		26 (9.1)		8 (0.6)
Smoking index, pack-years, mean (SD) [95% CI]	242	62.1 (105.8) [48.7 to 75.5]	1261	63.9 (89.5) [58.9 to 68.8]	0.785
Years from COPD diagnosis, mean (SD) [95% CI]	267	7.7 (7.3) [6.9 to 8.6]	1235	9.2 (8) [8.7 to 9.6]	0.007
Comorbidities	286		1314
Yes		237 (82.9)		1105 (84.1)	0.595
Number of comorbidities, mean (SD) [95% CI]	286	2.0 (1.4) [1.8 to 2.2]		2 (1.4) [1.9 to 2.1]	0.862
Spirometry, mean (SD) [95% CI]
FVC, mL	222	2360.9 (782.4) [2257.5 to 2464.4]	1008	2533.9 (883.7) [2479.2 to 2588.5]	0.007
FVC, %	229	77.5 (13.0) [75.8 to 79.2]	1094	72.7 (14.5) [71.8 to 73.5]	< 0.001
FEV1, mL	223	1295.1 (503.2) [1228.7 to 1361.5]	1009	1363.7 (561.5) [1329.1 to 1398.4]	0.092
FEV1, %	245	59.6 (14.0) [57.8 to 61.3]	1093	53.6 (15.1) [52.7 to 54.4]	< 0.001
FVC/FEV1	236	57.7 (11.1) [56.3 to 59.1]	1115	54.8 (12.3) [54.1 to 55.6]	< 0.001
Dyspnea	283		1301		0.132
Grade 0		16 (5.6)		81 (6.2)
Grade 1		114 (40.3)		455 (35)
Grade 2		105 (37.1)		456 (35.1)
Grade 3		42 (14.8)		274 (21.1)
Grade 4		6 (2.1)		35 (2.7)
6-min walking test, m	286		822		0.537
≥ 350		67 (23.4)		338 (41.1)
250–349		64 (22.4)		251 (30.5)
150–249		40 (14.0)		160 (19.5)
< 149		15 (5.2)		73 (8.9)
Severe exacerbations previous year, mean (SD) [95% CI]	278	0.9 (1.3) [0.8 to 1.1]	1279	1 (1.3) [0.9 to 1]	0.747
Two or more moderate-severe exacerbations	286	113 (39.5)	1307	553 (42.3)	0.390
CAT score, mean (SD) [95% CI]	281	21.2 (8.7) [20.2 to 22.2]	1301	20.8 (9) [20.3 to 21.3]	0.546
COPD impact according to CAT	281		1301		0.137
None, score < 5		13 (4.6)		41 (3.2)
Low, score 5–9		17 (6.0)		111 (8.5)
Medium, score 10–20		90 (32.0)		467 (35.9)
High, score > 20		123 (43.8)		487 (37.4)
Very high, score > 30		38 (13.5)		195 (15)
BODEx index, mean (SD) [95% CI]	252	2.3 (1.7) [2.1 to 2.5]	1167	2.9 (2) 2.7 to 3]	< 0.001
0–2 points		145 (57.5)		545 (46.7)	< 0.001
3–4 points		80 (31.7)		368 (31.5)
5–6 points		25 (9.9)		210 (18)
≥ 7 points		2 (0.8)		44 (3.8)

Note: Data expressed as frequencies and percentages in parenthesis unless otherwise stated.

Abbreviations: CI, confidence interval; FVC, forced vital capacity; FEV₁, forced expiratory volume in 1 s; BODEx, body mass index, airflow obstruction, dyspnea, and exacerbations; CAT, COPD Assessment Test.

Table 2 Distribution Of Clinical Characteristics In 286 Women With COPD According To COPD Phenotypes

Variables	COPD Phenotypes				P value
	Non-Exacerbator	ACOS	Exacerbator With Emphysema	Exacerbator With Chronic Bronchitis
Sex
Male	618 (47.9)	167 (12.9)	209 (16.2)	296 (22.9)	0.002
Female	117 (42.2)	60 (21.7)	48 (17.3)	52 (18.8)
Age, years
35–60	45 (44.5)	22 (21.8)	15 (14.8)	19 (18.8)	0.104
61–65	27 (44.3)	14 (22.9)	15 (24.6)	5 (8.2)
66–75	29 (40.3)	11 (15.3)	11 (15.3)	21 (29.2)
> 75	13 (36.1)	12 (33.3)	5 (13.9)	6 (16.7)
Physician specialty
Primary care	35 (32.1)	27 (24.8)	19 (17.4)	28 (25.7)	0.0004
Pneumology	63 (57.3)	17 (15.4)	19 (17.3)	11 (10.0)
Smoking status
Current smoker	64 (43.5)	25 (17.0)	28 (19.0)	30 (20.4)	0.438
Ex-smoker	42 (40.4)	27 (26.0)	18 (17.3)	17 (16.3)
Never-smoker	11 (44.0)	8 (32.0)	2 (8.0)	4 (16.0)
Comorbidities, mean (SD)	1.77 (1.28)	2.17 (1.51)	1.92 (1.29)	2.50 (1.57)	0.03
One	31 (26.5)	6 (10.0)	12 (25.0)	9 (17.1)	0.281
Two	34 (29.1)	18 (30.0)	14 (29.2)	16 (30.8)
Three	18 (15.4)	13 (21.7)	9 (18.7)	13 (25.0)
More than three	13 (11.1)	11 (18.3)	6 (12.5)	10 (19.2)
CAT score, mean (SD)	17.8 (8.2)	23.6 (6.9)	24.5 (9.0)	22.4 (9.4)	< 0.001
COPD impact according to CAT
None, score < 5	8 (6.9)	0	2 (4.3)	3 (5.9)	< 0.001
Low, score 5–9	13 (11.2)	2 (3.3)	1 (2.2)	1 (2.0)
Medium, score 10–20	49 (42.2)	17 (28.3)	8 (17.4)	14 (27.4)
High, score > 20	39 (33.6)	32 (53.3)	22 (47.8)	24 (47.1)
Very high, score > 30	7 (6.0)	9 (15.0)	13 (28.3)	9 (17.6)
BODEx index
0–2 points	81 (57.4)	30 (21.3)	10 (7.1)	20 (14.2)	< 0.001
3–4 points	19 (24.7)	15 (19.5)	24 (31.2)	19 (24.7)
5–6 points	5 (20.0)	5 (20.0)	9 (36.0)	6 (24.0)
≥ 7 points	0	1 (50.0)	0	1 (50.0)

Note: Data expressed as frequencies and percentages in parenthesis unless otherwise stated.

Abbreviations: ACOS, asthma-COPD overlap syndrome; CAT, COPD Assessment Test; BODEx, body mass index, airflow obstruction, dyspnea, and exacerbations.

Figure 1 Differences in the overall prevalence of COPD phenotypes between women and men.

Figure 2 Impact of COPD in the patient’s quality of life according to the CAT score.