Machado Maria-Christina L, Krishnan Jerry A, Buist Sonia A, Bilderback Andrew L, Fazolo Guilherme P, Santarosa Michelle G, Queiroga Fernando, Vollmer William M
State Public Hospital of São Paulo, São Paulo, Brazil.
Am J Respir Crit Care Med. 2006 Sep 1;174(5):524-9. doi: 10.1164/rccm.200507-1057OC. Epub 2006 Jun 15.
Chronic obstructive pulmonary disease (COPD) is a leading cause of death worldwide. The prevalence of COPD is rising among women and is approaching that of men, but it is not known if sex affects survival.
To measure the survival differences between men and women with oxygen-dependent COPD.
We conducted a 7-yr prospective cohort study of 435 outpatients with COPD (184 women, 251 men) referred for long-term oxygen therapy (LTOT) at two respiratory clinics in Sao Paulo, Brazil. Baseline data were collected on enrollment into oxygen therapy, when patients were clinically stable.
We examined the effect of sex on survival using Kaplan-Meier survival curves, and then used Cox proportional hazards models to control for potential confounders.
In unadjusted analyses, we observed a nonsignificant trend toward increased mortality for women (hazard ratio, 1.28; 95% confidence interval, 0.98-1.68; p = 0.07). After accounting for potential confounders (age, pack-years smoked, Pa(O(2)), FEV(1), body mass index), females were at a significantly higher risk of death (hazard ratio, 1.54; 95% confidence interval, 1.15-2.07; p = 0.004). Other independent predictors of death were lower Pa(O(2)) (p < 0.001) and lower body mass index (p < 0.05).
Among patients with COPD on LTOT, women were more likely to die than men.
慢性阻塞性肺疾病（COPD）是全球主要的死亡原因之一。COPD在女性中的患病率正在上升，接近男性患病率，但尚不清楚性别是否会影响生存率。
测量依赖氧气治疗的COPD男性和女性之间的生存差异。
我们在巴西圣保罗的两家呼吸诊所对435名接受长期氧疗（LTOT）的COPD门诊患者（184名女性，251名男性）进行了为期7年的前瞻性队列研究。在患者临床稳定时，收集了入组氧疗时的基线数据。
我们使用Kaplan-Meier生存曲线检查性别对生存的影响，然后使用Cox比例风险模型控制潜在的混杂因素。
在未调整的分析中，我们观察到女性死亡率增加的趋势不显著（风险比，1.28；95%置信区间，0.98 - 1.68；p = 0.07）。在考虑潜在的混杂因素（年龄、吸烟包年数、Pa(O₂)、FEV₁、体重指数）后，女性的死亡风险显著更高（风险比，1.54；95%置信区间，1.15 - 2.07；p = 0.004）。其他死亡的独立预测因素是较低的Pa(O₂)（p < 0.001）和较低的体重指数（p < 0.05）。
在接受LTOT的COPD患者中，女性比男性更易死亡。
