Do females behave differently in COPD exacerbation?

Figures & data

Table 1 Characteristics of the patients

	Females (n=109) (%)	Males (n=275) (%)	P
Age (mean ± SD years)	66.69±11.19	68.94±10.11	0.16
BMI (kg/m^2)	28.26±7.08	25.0±5.75	0.00
Smoking, n (%)	44 (40.7)	261 (94.9)	0.00
Current smoker	14 (23.3)	70 (26.2)
Ex-smoker	30 (50)	179 (67)
Passive smoker	16 (26.7)	18 (6.7)
Biomass exposure, n (%)	23 (46.9)	21 (48.8)	1
Asbestos exposure, n (%)	10 (20.4)	2 (7.4)	0.2
Duration of COPD (years)	6.27±6.13	8.01±5.33	0.00
Spirometric severity of COPD*			0.001
Stage 1, n (%)	0 (0)	9 (3.3)	0.00
Stage 2, n (%)	27 (24.8)	61 (22.2)
Stage 3, n (%)	49 (45)	67 (24.4)
Stage 4, n (%)	33 (30.2)	138 (50.1)
FEV1/FVC at admission	0.645±0.14	0.587±0.18	0.00
FEV1(mL/sn) at admission	877.9±388.4	1,038.1±496.8	0.00
FEV1% at admission	48.9±15.6	40.9±17.6	0.00
FVC (mL) at admission	1,401.7±644.5	1,807.7±736.6	0.00
PO2	36.28±8.1	57.93±12.5	0.00
PCO2	45.97±7.5	42.49±11.3	0.00

Note:

* Spirometrik severity defined by GOLD.

Abbreviations: BMI, body mass index; FEV₁, forced expiratory volume in 1 second; FVC, forced vital capacity; GOLD, Global Initiative for Obstructive lung Disease; PO₂, partial oxygen pressure; PCO₂, partial carbon dioxide pressure.

Table 2 Characteristics of exacerbations in the previous year

	Females (n=109) (%)	Males (n=275) (%)	P
Mean no of exacerbation ± SD	1.81±1.0	1.78±1.27	0.87
Number (%) of exacerbated pts in the previous year	101 (92.7)	227 (82.5)	0.001
Number (%) of pts with no exacerbations	–	–	0.55
Number (%) of pts with one exacerbation	8 (7.339)	48 (17.454)
Number (%) of pts with two exacerbations	55 (50.458)	114 (41.454)
Number (%) of pts with three or more exacerbations	46 (42.203)	113 (41.092)
History of receiving antibiotics due to exacerbation in the previous year
Mean no of antibiotic cycles ± SD per patient	1.42±1.30	1.29±0.94	0.82
Number (%) of pts did not receive antibiotics	26 (23.85)	44 (16)	0.82
Number (%) of pts received one or two cycles of antibiotics	66 (60.56)	207 (75.273)
Number (%) of pts received three or more cycles of antibiotics	17 (15.59)	24 (8.727)
Hospitalization due to exacerbation in the previous year
Mean no of hospitalization ± SD	1.61±1.27	1.51±0.78	0.34
Number (%) of pts with one hospitalization	3 (2.75)	32 (11.63)	0.01
Number (%) of pts with two hospitalization	104 (95.42)	240 (87.27)
Number (%) of pts with three or more hospitalization	2 (1.83)	3 (1.00)
Length of hospitalization (mean ± SD) (days)	12.02±7.09	12.2±7.10	0.97
Number (%) of pts hospitalized for less than 7 days	67 (61.46)	184 (66.90)	0.001
Number (%) of pts hospitalized for 7–14 days	16 (14.67)	78 (28.36)
Number (%) of pts hospitalized for more than 15 days	26 (23.87)	13 (4.74)
ICU admission due to exacerbation in the previous year
Mean number of ICU admission ± SD	0.14±0.42	0.22±0.49	0.08
Number (%) of pts with no ICU admission	97 (89)	229 (83.28)
Number (%) of pts with one admission	9 (8.25)	39 (14.18)	0.25
Number (%) of pts with two to more admissions	3 (2.75)	7 (2.54)
Mean no of intubation ± SD	0.07±0.32	0.09±0.30	0.33
Number (%) of pts with no intubation	101 (92.68)	251 (91.28)	0.09
Number (%) of pts with one intubation	4 (3.66)	23 (8.36)
Number (%) of pts with two or more intubations	4 (3.66)	1 (0.36)

Abbreviations: pts, patients; ICU, intensive care unit; SD, standard deviation.

Table 3 Characteristics of the current admission for exacerbation

	Females (n=109) (%)	Males (n=275) (%)	P
Mean time (days) after symptoms started till the patients were admitted to the ward	47.82±15.84	12.34±10.09	0.001
Hospitalization duration for current exacerbation (mean ± SD) (days)	36.80±4.43	12.32±6.96	0.001
Etiologies of exacerbation symptoms, n (%)
Number (%) of the pts with tracheobronchial infections (AECOPD)	41 (37.62)	81 (29.45)
Number (%) of the pts with pneumonia	12 (11)	79 (28.72)
Number (%) of the pts with pulmonary embolism	5 (4.6)	5 (1.81)
Number (%) of the pts with congestive heart failure	10 (9.2)	19 (6.90)	0.001
Number (%) of the pts with low treatment adherence	19 (17.39)	35 (12.72)
Number (%) of the pts with infected bronchiectasis	3 (2.8)	10 (3.63)
Number (%) of the pts with other reasons	19 (17.39)	46 (16.77)

Abbreviations: pts, patients; AECOPD, acute exacerbation of chronic obstructive lung disease; SD, standard deviation.

Table 4 Comorbidities of the patients

	Females (n=109) (%)	Males (n=275) (%)	P
The mean ± SD of comorbidities	0.05±0.21	3.22±1.99	0.00
The mean Charlson index ± SD	0.48±0.50	3.53±2.07	0.00
Charlson index no (%)
0	56 (51.4)	41 (15)	0.00
1	53 (48.6)	49 (17.9)
≥2	0	185 (67.1)
Sleep disorders	13 (11.92)	13 (4.72)	0.02
Hypertension	20 (18.34)	145 (52.72)	0.00
Arrhythmia	15 (13.76)	67 (24.36)	0.03
Coronary artery disease	34 (31.19)	89 (32.36)	0.82
Diabetes mellitus	5 (4.58)	62 (22.54)	0.00
Congestive heart failure	5 (4.58)	70 (25.45)	0.00
Hyperlipidemia	2 (1.83)	26 (9.45)	0.00
Lung cancer	24 (22.01)	70 (25.45)	0.51
Other cancers	3 (2.75)	19 (6.90)	0.14
Bronchiectasis	1 (0.91)	59 (21.45)	0.00
Chronic kidney disease	11 (10.09)	9 (3.27)	0.00
Anemia	26 (30.2)	12 (4.4)	0.00
Gastroesophageal reflux	96 (87.1)	41 (14.9)	0.00

Abbreviation: SD, standard deviation.

Table 5 Comparison of the drug treatment for COPD

	Females (n=109) (%)	Males (n=275) (%)	P
Short-acting β2-adrenergic agonists	40 (36.69)	264 (96.0)	0.00
Long-acting β2-adrenergic agonists	35 (32.11)	220 (80)	0.00
Short-acting anticholinergic agents	50 (45.87)	58 (21.09)	0.00
Long-acting anticholinergic agents	72 (66.05)	230 (83.63)	0.01
Inhaler corticosteroids	40 (36.69)	228 (82.90)	0.00
Oral corticosteroids	30 (27.52)	3 (1.1)	0.00
Theophylline	3 (2.75)	35 (12.72)	0.00