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      Do females behave differently in COPD exacerbation?

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          Abstract

          Introduction

          Little is known about whether there is any sex effect on chronic obstructive lung disease (COPD) exacerbations. This study is intended to describe the possible sex-associated differences in exacerbation profile in COPD patients.

          Methods

          A total of 384 COPD patients who were hospitalized due to exacerbation were evaluated retrospectively for their demographics and previous and current exacerbation characteristics.

          Results

          The study was conducted on 109 (28%) female patients and 275 (72%) male patients. The mean age was 68.30±10.46 years. Although females had better forced expiratory volume in 1 second and near-normal forced vital capacity, they had much impaired arterial blood gas levels (partial oxygen pressure [PO 2] was 36.28 mmHg vs 57.93 mmHg; partial carbon dioxide pressure [PCO 2] was 45.97 mmHg vs 42.49 mmHg; P=0.001), indicating severe exacerbation with respiratory failure. More females had two exacerbations and two hospitalizations, while more men had one exacerbation and one hospitalization. Low adherence to treatment and pulmonary embolism were more frequent in females. Females had longer time from the onset of symptoms till the admission and longer hospitalization duration than males. Comorbidities were less in number and different in women ( P<0.05). Women were undertreated and using more oral corticosteroids.

          Conclusion

          Current data showed that female COPD patients might be more prone to have severe exacerbations, a higher number of hospitalizations, and prolonged length of stay for hospitalization. They have a different comorbidity profile and might be undertreated for COPD.

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          Most cited references 28

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          Standards for the diagnosis and treatment of patients with COPD: a summary of the ATS/ERS position paper.

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            Gender differences in airway behaviour over the human life span.

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              Gender and chronic obstructive pulmonary disease: why it matters.

              The prevalence of chronic obstructive pulmonary disease (COPD) in women is increasing, as is hospitalization for COPD. The number of women dying of COPD in the United States now surpasses men. Despite this, research suggests that physicians are still more likely to correctly diagnose men with COPD than women. Increased tobacco use in women likely explains some of the increase in the prevalence of COPD in women, but data suggest that women may actually be at greater risk of smoking-induced lung function impairment, more severe dyspnea, and poorer health status for the same level of tobacco exposure. The degree to which these observations represent biologic, physiologic, or sociologic differences is not known. Nonsmokers with COPD are also more likely to be female. In addition, new evidence is emerging that men and women may be phenotypically different in their response to tobacco smoke, with men being more prone to an emphysematous phenotype and women an airway predominant phenotype. Inasmuch as COPD is a disease of inflammation, it is also possible that sexual dimorphism of the human immune response may also be responsible for gender differences in the disease. More data are still needed on what the implications of these findings are on therapy. In this clinical commentary, we present current knowledge regarding how gender influences the epidemiology, diagnosis, and presentation of COPD in addition to physiologic and psychologic impairments and we attempt to offer insight into why these differences might exist and how this may influence therapeutic management.
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                Author and article information

                Journal
                Int J Chron Obstruct Pulmon Dis
                Int J Chron Obstruct Pulmon Dis
                International Journal of COPD
                International Journal of Chronic Obstructive Pulmonary Disease
                Dove Medical Press
                1176-9106
                1178-2005
                2015
                24 April 2015
                : 10
                : 823-830
                Affiliations
                [1 ]Department of Pulmonary Medicine, Ankara Atatürk Training and Research Hospital, Gazi University, Ankara, Turkey
                [2 ]Department of Pulmonary Medicine, School of Medicine, Gazi University School of Medicine, Gazi University, Ankara, Turkey
                [3 ]Department of Pulmonary Medicine, Dr. Nafiz Körez Sincan Devlet Hastanesi, Gazi University, Ankara, Turkey
                [4 ]Department of Public Health, School of Medicine, Gazi University, Ankara, Turkey
                Author notes
                Correspondence: Nurdan Kokturk, Department of Pulmonary Medicine, School of Medicine, Gazi University School of Medicine, 06500 Besevler, Ankara, Turkey, Tel +90 312 202 6121, Fax +90 312 212 9019, Email kokturk.nurdan@ 123456gmail.com
                Article
                copd-10-823
                10.2147/COPD.S78952
                4418390
                25977604
                © 2015 Kilic et al. This work is published by Dove Medical Press Limited, and licensed under Creative Commons Attribution – Non Commercial (unported, v3.0) License

                The full terms of the License are available at http://creativecommons.org/licenses/by-nc/3.0/. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.

                Categories
                Original Research

                Respiratory medicine

                comorbidities, female, sex, exacerbation, copd

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