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Impact of gender on chronic obstructive pulmonary disease outcomes: a propensity score-matched analysis of a prospective cohort study.

ABSTRACT: BACKGROUND/AIMS:Despite increasing awareness of the burden of chronic obstructive pulmonary disease (COPD) in women, knowledge regarding gender differences in COPD outcomes is limited. Therefore, we aimed to evaluate whether COPD outcomes, including exacerbations, lung function, and symptoms differ by gender. METHODS:We recruited patients with COPD from two Korean multicenter prospective cohorts. After propensity score matching, the main outcome, the incidence of moderate or severe exacerbations was analyzed using a negative binomial regression model. We also assessed changes in lung function and symptom scores including the St. George's respiratory questionnaire for COPD (SGRQ-C), COPD assessment test (CAT), and the modified Medical Research Council (mMRC) dyspnea score. RESULTS:After propensity score matching, 74 women and 74 men with COPD were included. The incidence rates of exacerbations in women and men were not significantly different (incidence rate ratio, 1.49; 95% confidence interval [CI], 0.88 to 2.54). There was no significant difference in the incidence rates adjusted for medication possession ratios of long-acting muscarinic antagonists, long-acting ?-agonists, and inhaled corticosteroids during the follow-up period (incidence rate ratio, 1.47; 95% CI, 0.86 to 2.52). Rates of decline in post-bronchodilator forced expiratory volume in 1 second and forced vital capacity did not differ between women and men during 48 months of follow-up. The changes in scores on the SGRQ-C, CAT, and mMRC Questionnaire in women were also similar to those in men. CONCLUSION:We observed no gender differences in the rate of exacerbations of COPD in a prospective longitudinal study. Further studies are needed to confirm these findings in the general COPD population.

SUBMITTER: Cho J

PROVIDER: S-EPMC7487291 | biostudies-literature | 2020 Sep

REPOSITORIES: biostudies-literature

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Impact of gender on chronic obstructive pulmonary disease outcomes: a propensity score-matched analysis of a prospective cohort study.

Cho Jaeyoung J Lee Chang-Hoon CH Kim Deog Kyeom DK Hwang Hun-Gyu HG Kim Yu-Il YI Choi Hye Sook HS Park Jeong-Woong JW Yoo Kwang Ha KH Jung Ki-Suck KS Lee Sang-Do SD

The Korean journal of internal medicine 20200227 5

<h4>Background/aims</h4>Despite increasing awareness of the burden of chronic obstructive pulmonary disease (COPD) in women, knowledge regarding gender differences in COPD outcomes is limited. Therefore, we aimed to evaluate whether COPD outcomes, including exacerbations, lung function, and symptoms differ by gender.<h4>Methods</h4>We recruited patients with COPD from two Korean multicenter prospective cohorts. After propensity score matching, the main outcome, the incidence of moderate or sever ...[more]

PMID: 32098456

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Project description:Background The optimal treatment for pulmonary metastases has not been determined, and the survival benefit of surgical resection in selected patients remains controversial. The purpose of this retrospective study was to explore whether surgery can prolong survival in patients with pulmonary metastases compared with chemotherapy, and to analyze the factors that may affect the long-term survival of patients with pulmonary metastases. Methods We retrospectively analyzed the medical records of patients with pulmonary metastases from June 2012 to June 2019. Propensity score matching (PSM) was used to balance factors that might affect survival between the two groups. The data were analyzed by Kaplan-Meier survival analysis and Cox proportional hazards models to compare the survival of the surgery group and the chemotherapy group. Results A total of 202 patients with pulmonary metastases were enrolled in the study, with 43 patients in the surgery group and 43 in the chemotherapy group after screening and PSM. After PSM, patients in the surgery group had better survival than those in the chemotherapy group, with 5-year overall survival (OS) rates of 75.1% and 48.0%, respectively (P=0.017). Univariate analysis of the two groups of patients found that the treatment method, the number of metastases, and the total diameter of metastases were prognostic factors, but multivariate analysis did not find independent prognostic factors. In the surgical group, univariate analysis found that disease-free interval (DFI), the number of metastases, surgical methods, resection scope and surgical route were prognostic factors, and multivariate analysis showed that only DFI was an independent prognostic factor. In the chemotherapy group, DFI and the response of metastases to chemotherapy were found to be prognostic factors in univariate analysis, but no independent prognostic factors were found in multivariate analysis. Conclusions Surgery does not provide a significant survival advantage. For patients undergoing surgery, longer DFI predicts better survival.

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Impact of gender on chronic obstructive pulmonary disease outcomes: a propensity score-matched analysis of a prospective cohort study.

Publications

Impact of gender on chronic obstructive pulmonary disease outcomes: a propensity score-matched analysis of a prospective cohort study.

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