Sex differences in comorbidities and mortality risk among patients with chronic obstructive pulmonary disease: a study based on NHANES data
Abstract Background Patients with chronic obstructive pulmonary disease (COPD) commonly have coexisting comorbidities that contribute to higher exacerbation frequency, poorer health status, and increased all-cause mortality; however, there are only a few studies available on the sex discrepancy in t...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-11-01
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| Series: | BMC Pulmonary Medicine |
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| Online Access: | https://doi.org/10.1186/s12890-023-02771-3 |
| _version_ | 1827604544078479360 |
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| author | Na Li Xiaoli Li Minjie Liu Yakang Wang Junning Wang |
| author_facet | Na Li Xiaoli Li Minjie Liu Yakang Wang Junning Wang |
| author_sort | Na Li |
| collection | DOAJ |
| description | Abstract Background Patients with chronic obstructive pulmonary disease (COPD) commonly have coexisting comorbidities that contribute to higher exacerbation frequency, poorer health status, and increased all-cause mortality; however, there are only a few studies available on the sex discrepancy in the comorbidity distribution and outcomes among COPD patients, and there is limited information about the discrepancy in all-cause mortality between men and women. Methods Based on data from the U.S. National Health and Nutrition Examination Survey conducted between 2007 and 2012, we compared participants aged 40–79 years with spirometry-defined COPD to compare the prevalence of comorbidities between men and women. The survival of the subjects was documented, and the sex discrepancy was determined using Kaplan–Meier analysis. Comorbidities and all-cause mortality were analyzed by using a Cox proportional hazards model to determine their strength of association in different sex groups. Results Compared to men, women had a significantly higher prevalence of asthma (OR 1.93, 95% CI 1.46 to 2.57, p < 0.001) and arthritis (OR 1.77, 95% CI 1.39 to 2.24, p < 0.001). Women had a significantly lower prevalence of coronary heart disease (OR 0.48, 95% CI 0.27 to 0.87, p = 0.015) and gout (OR 0.42, 95% CI 0.25 to 0.67, p = 0.001). Kaplan–Meier analysis revealed that compared with that of the female group, the survival rate of the male group was significantly lower (p < 0.001). Among men, the presence of anemia (HR 2.38, [95% CI 1.52–3.73], p < 0.001), gout (HR 1.55, [95% CI 1.04–2.30], p = 0.029) and congestive heart failure comorbidities (HR 1.85, [95% CI 1.12–3.04] p = 0.016) was associated with a higher risk of mortality; among women, the presence of anemia (HR 2.21, [95% CI 1.17–4.20], p = 0.015) and stroke (HR 2.04, [95% CI 1.07–3.88], p = 0.031) comorbidities was associated with a higher risk of mortality after adjusting for age, race/Hispanic status, BMI, smoking status, FEV1% predicted and prevalent comorbidities. Conclusions COPD-related comorbidities and all-cause mortality were discrepant between men and women, and men had poorer survival than women in the nationally representative data that were analyzed. |
| first_indexed | 2024-03-09T06:01:36Z |
| format | Article |
| id | doaj.art-b9eac439b8734d5a85c91099233ddf27 |
| institution | Directory Open Access Journal |
| issn | 1471-2466 |
| language | English |
| last_indexed | 2024-03-09T06:01:36Z |
| publishDate | 2023-11-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Pulmonary Medicine |
| spelling | doaj.art-b9eac439b8734d5a85c91099233ddf272023-12-03T12:08:57ZengBMCBMC Pulmonary Medicine1471-24662023-11-0123111010.1186/s12890-023-02771-3Sex differences in comorbidities and mortality risk among patients with chronic obstructive pulmonary disease: a study based on NHANES dataNa Li0Xiaoli Li1Minjie Liu2Yakang Wang3Junning Wang4Department of Respiratory, Honghui Hospital, Xi’an Jiaotong UniversityDepartment of Respiratory, Honghui Hospital, Xi’an Jiaotong UniversityDepartment of Respiratory, Honghui Hospital, Xi’an Jiaotong UniversityDepartment of Orthopaedics, Honghui Hospital, Xi’an Jiaotong UniversityDepartment of Respiratory, Honghui Hospital, Xi’an Jiaotong UniversityAbstract Background Patients with chronic obstructive pulmonary disease (COPD) commonly have coexisting comorbidities that contribute to higher exacerbation frequency, poorer health status, and increased all-cause mortality; however, there are only a few studies available on the sex discrepancy in the comorbidity distribution and outcomes among COPD patients, and there is limited information about the discrepancy in all-cause mortality between men and women. Methods Based on data from the U.S. National Health and Nutrition Examination Survey conducted between 2007 and 2012, we compared participants aged 40–79 years with spirometry-defined COPD to compare the prevalence of comorbidities between men and women. The survival of the subjects was documented, and the sex discrepancy was determined using Kaplan–Meier analysis. Comorbidities and all-cause mortality were analyzed by using a Cox proportional hazards model to determine their strength of association in different sex groups. Results Compared to men, women had a significantly higher prevalence of asthma (OR 1.93, 95% CI 1.46 to 2.57, p < 0.001) and arthritis (OR 1.77, 95% CI 1.39 to 2.24, p < 0.001). Women had a significantly lower prevalence of coronary heart disease (OR 0.48, 95% CI 0.27 to 0.87, p = 0.015) and gout (OR 0.42, 95% CI 0.25 to 0.67, p = 0.001). Kaplan–Meier analysis revealed that compared with that of the female group, the survival rate of the male group was significantly lower (p < 0.001). Among men, the presence of anemia (HR 2.38, [95% CI 1.52–3.73], p < 0.001), gout (HR 1.55, [95% CI 1.04–2.30], p = 0.029) and congestive heart failure comorbidities (HR 1.85, [95% CI 1.12–3.04] p = 0.016) was associated with a higher risk of mortality; among women, the presence of anemia (HR 2.21, [95% CI 1.17–4.20], p = 0.015) and stroke (HR 2.04, [95% CI 1.07–3.88], p = 0.031) comorbidities was associated with a higher risk of mortality after adjusting for age, race/Hispanic status, BMI, smoking status, FEV1% predicted and prevalent comorbidities. Conclusions COPD-related comorbidities and all-cause mortality were discrepant between men and women, and men had poorer survival than women in the nationally representative data that were analyzed.https://doi.org/10.1186/s12890-023-02771-3ComorbiditiesCOPDSex differencesSurvival |
| spellingShingle | Na Li Xiaoli Li Minjie Liu Yakang Wang Junning Wang Sex differences in comorbidities and mortality risk among patients with chronic obstructive pulmonary disease: a study based on NHANES data BMC Pulmonary Medicine Comorbidities COPD Sex differences Survival |
| title | Sex differences in comorbidities and mortality risk among patients with chronic obstructive pulmonary disease: a study based on NHANES data |
| title_full | Sex differences in comorbidities and mortality risk among patients with chronic obstructive pulmonary disease: a study based on NHANES data |
| title_fullStr | Sex differences in comorbidities and mortality risk among patients with chronic obstructive pulmonary disease: a study based on NHANES data |
| title_full_unstemmed | Sex differences in comorbidities and mortality risk among patients with chronic obstructive pulmonary disease: a study based on NHANES data |
| title_short | Sex differences in comorbidities and mortality risk among patients with chronic obstructive pulmonary disease: a study based on NHANES data |
| title_sort | sex differences in comorbidities and mortality risk among patients with chronic obstructive pulmonary disease a study based on nhanes data |
| topic | Comorbidities COPD Sex differences Survival |
| url | https://doi.org/10.1186/s12890-023-02771-3 |
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