中国慢性阻塞性肺疾病急性加重期住院患者的特征、治疗、住院及长期结局：一项大型队列研究中的性别差异
Characteristics, treatments, in-hospital and long-term outcomes among inpatients with acute exacerbation of chronic obstructive pulmonary disease in China: sex differences in a large cohort study.
作者信息
Zhang Jiarui, Yi Qun, Zhou Chen, Luo Yuanming, Wei Hailong, Ge Huiqing, Liu Huiguo, Zhang Jianchu, Li Xianhua, Xie Xiufang, Pan Pinhua, Yi Mengqiu, Cheng Lina, Zhou Hui, Liu Liang, Aili Adila, Liu Yu, Peng Lige, Pu Jiaqi, Zhou Haixia
机构信息
Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Guo-xue-xiang 37#, Wuhou District, 610041, Chengdu, Sichuan Province, China.
Sichuan Cancer Hospital, University of Electronic Science and Technology of China, Chengdu, Sichuan Province, China.
出版信息
BMC Pulm Med. 2024 Mar 11;24(1):125. doi: 10.1186/s12890-024-02948-4.
BACKGROUND
Data related to the characteristics, treatments and clinical outcomes of acute exacerbation of chronic obstructive pulmonary disease (AECOPD) patients in China are limited, and sex differences are still a neglected topic.
METHODS
The patients hospitalized for AECOPD were prospectively enrolled from ten medical centers in China between September 2017 and July 2021. Patients from some centers received follow-up for 3 years. Data regarding the characteristics, treatments and in-hospital and long-term clinical outcomes from male and female AECOPD patients included in the cohort were analyzed and compared.
RESULTS
In total, 14,007 patients with AECOPD were included in the study, and 11,020 (78.7%) were males. Compared with males, female patients were older (74.02 ± 10.79 vs. 71.86 ± 10.23 years, P < 0.001), and had more comorbidities (2.22 ± 1.64 vs. 1.73 ± 1.56, P < 0.001), a higher frequency of altered mental status (5.0% vs. 2.9%, P < 0.001), lower diastolic blood pressure (78.04 ± 12.96 vs. 79.04 ± 12.47 mmHg, P < 0.001). In addition, there were also significant sex differences in a range of laboratory and radiographic findings. Females were more likely to receive antibiotics, high levels of respiratory support and ICU admission than males. The in-hospital and 3-year mortality were not significantly different between males and females (1.4% vs. 1.5%, P = 0.711; 35.3% vs. 31.4%, P = 0.058), while female smokers with AECOPD had higher in-hospital mortality than male smokers (3.3% vs. 1.2%, P = 0.002) and male smokers exhibited a trend toward higher 3-year mortality compared to female smokers (40.7% vs. 33.1%, P = 0.146).
CONCLUSIONS
In AECOPD inpatients, females and males had similar in-hospital and long-term survival despite some sex differences in clinical characteristics and treatments, but female smokers had significantly worse in-hospital outcomes than male smokers.
CLINICAL TRIAL REGISTRATION
Retrospectively registered, registration number is ChiCTR2100044625, date of registration 21/03/2021. URL: http://www.chictr.org.cn/showproj.aspx?proj=121626 .
背景
中国慢性阻塞性肺疾病急性加重（AECOPD）患者的特征、治疗及临床结局相关数据有限，性别差异仍是一个被忽视的话题。
方法
2017年9月至2021年7月，在中国10个医疗中心前瞻性纳入因AECOPD住院的患者。部分中心的患者接受了3年随访。对队列中纳入的男性和女性AECOPD患者的特征、治疗以及住院和长期临床结局数据进行分析和比较。
结果
该研究共纳入14007例AECOPD患者，其中男性11020例（78.7%）。与男性相比，女性患者年龄更大（74.02±10.79岁 vs. 71.86±10.23岁，P<0.001），合并症更多（2.22±1.64 vs. 1.73±1.56，P<0.001），精神状态改变的频率更高（5.0% vs. 2.9%，P<0.001），舒张压更低（78.04±12.96 vs. 79.04±12.47 mmHg，P<0.001）。此外，一系列实验室和影像学检查结果也存在显著性别差异。女性比男性更有可能接受抗生素治疗、高水平呼吸支持和入住重症监护病房。男性和女性的住院死亡率和3年死亡率无显著差异（1.4% vs. 1.5%，P=0.711；35.3% vs. 31.4%，P=0.058），而患有AECOPD的女性吸烟者的住院死亡率高于男性吸烟者（3.3% vs. 1.2%，P=0.002），与女性吸烟者相比，男性吸烟者有3年死亡率更高的趋势（40.7% vs. 33.1%，P=0.146）。
结论
在AECOPD住院患者中，尽管临床特征和治疗存在一些性别差异，但男性和女性的住院和长期生存率相似，但女性吸烟者的住院结局明显比男性吸烟者差。
临床试验注册
回顾性注册，注册号为ChiCTR2100044625，注册日期为2021年3月21日。网址：http://www.chictr.org.cn/showproj.aspx?proj=121626 。
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