Diferencias clínicas y pronósticas de la enfermedad pulmonar obstructiva crónica en mujeres derivadas a rehabilitación respiratoria: una visión con enfoque de género

Abstract

Introduction

Respiratory rehabilitation programmes improve clinical and functional outcomes in patients with chronic obstructive pulmonary disease (COPD), but it is unknown whether their impact differs between men and women.

Objectives

To assess possible sex differences in semiology, comorbidities and prognosis in COPD patients referred to respiratory rehabilitation.

Material and methods

Post-hoc analysis of a prospective cohort of COPD patients referred to rehabilitation from December 2012 to January 2020. Mortality and hospitalisations adjusted for sex, age, severity and body mass index were assessed. Statistical tests used: Chi-square, Student's t, linear regression model and Kaplan-Meier survival curve.

Results

Of 173 patients (age 66.6 years; 70% severe COPD), there were 36 (20.8%) women. Compared to men, women were younger (–4.8 years [95% CI 1.5-8.0; P=.004]) and reported greater dyspnoea on the modified Medical Research Council scale (+0.4 points [95% CI 0.1-0.9; P=.026]). During follow-up, 21 (12.2%) patients died and 79 (45.9%) required ≥2 hospital admissions, with no significant differences between sexes. Despite having lower comorbidity (–0.8 Charlson index points [95% CI –1.3 to –0.3, P=.004]), women had a higher prevalence of depression (53.6% vs. 22.7%, P=.001) and anxiety (37% vs 16.7%, P=.020) than men.

Conclusions

Prognosis in terms of mortality and hospital admissions is not different between men and women. Women have a higher degree of dyspnoea and less comorbidity than men, although the prevalence of anxiety and depression is higher.