Internal Medicine Service, Hospital Mútua de Terrassa, Plaza Dr. Robert 5, Barcelona, Spain.
Respir Med. 2010 Feb;104(2):253-9. doi: 10.1016/j.rmed.2009.09.019. Epub 2009 Oct 30.
Patients hospitalized for a COPD exacerbation are usually of advanced age, with functional deterioration, and suffering an increased number of associated conditions, but little is known about gender differences. Our hypothesis is that the frequency and type of comorbidities differ in male and female COPD patients.
A cross-sectional, multicentre study of patients hospitalized for a COPD exacerbation. All of them had COPD confirmed by baseline forced spirometry with a bronchodilator test. Comorbidity information was collected using the Charlson index, and an ad hoc questionnaire that included other common conditions not included in the Charlson index.
We studied 398 patients, 353 men (89%) and 45 women (11%), with a mean (S.D.) age of 73.7 (8.9) years and a percent predicted FEV(1) of 43.2 (12.5). The mean score of the Charlson index was 2.7 (2.0), with no differences by gender; in contrast, the mean number of all comorbid conditions assessed was 3.7 (1.7) in men and 1.8 (1.8) in women (p < 0.05). Overall, 55% of the patients had arterial hypertension, 26% diabetes mellitus, 27% chronic heart failure, and 17% ischemic heart disease. Female COPD patients had a lower prevalence of ischemic heart disease (p = 0.008) and alcoholism (p = 0.03), but presented more frequently with chronic heart failure (p = 0.03), osteoporosis (p = 0.007) and diabetes mellitus without complications (p = 0.02).
Comorbidities are common in patients hospitalized for a COPD exacerbation, but their relative distribution varies by gender. The exclusive use of the Charlson index underestimates comorbidities in COPD patients.
因 COPD 加重而住院的患者通常年龄较大，存在功能恶化，且患有较多合并症，但关于性别差异的了解甚少。我们的假设是，男性和女性 COPD 患者的合并症频率和类型不同。
这是一项 COPD 加重住院患者的横断面、多中心研究。所有患者均通过基线支气管扩张剂后用力肺活量检查确诊为 COPD。使用 Charlson 指数收集合并症信息，并使用专门的问卷收集 Charlson 指数中未包含的其他常见合并症。
我们研究了 398 例患者，其中 353 例为男性（89%），45 例为女性（11%），平均（标准差）年龄为 73.7（8.9）岁，预计 FEV1 占预计值的百分比为 43.2（12.5）。Charlson 指数的平均评分为 2.7（2.0），性别间无差异；相比之下，男性评估的所有合并症的平均数量为 3.7（1.7），女性为 1.8（1.8）（p < 0.05）。总体而言，55%的患者患有动脉高血压，26%患有糖尿病，27%患有慢性心力衰竭，17%患有缺血性心脏病。女性 COPD 患者的缺血性心脏病患病率较低（p = 0.008）和酒精中毒（p = 0.03），但更常患有慢性心力衰竭（p = 0.03）、骨质疏松症（p = 0.007）和无并发症的糖尿病（p = 0.02）。
因 COPD 加重而住院的患者合并症较为常见，但它们的相对分布因性别而异。单独使用 Charlson 指数会低估 COPD 患者的合并症。
