Ozdemir Tarkan, Yıldız Murat, Arı Maşide, Arı Emrah, Eraslan Doğanay Güler, Cırık Mustafa Özgür, Doğancı Melek, Özdilekcan Çiğdem, Kızılgöz Derya, Şipit Yusuf Tuğrul
Department of Chest Diseases, Ankara Sanatoryum Training and Research Hospital, Ankara 06290, Turkey.
Department of Emergency Medicine, Mamak Public Hospital, Ankara 06620, Turkey.
Medicina (Kaunas). 2025 Mar 25;61(4):587. doi: 10.3390/medicina61040587.
To contribute to clinical practice by identifying gender-based differences in patients diagnosed with chronic obstructive pulmonary disease (COPD) who are monitored in the intensive care unit due to type 2 respiratory failure. The study was planned as a prospective, observational, and cross-sectional investigation. A total of 258 patients, 91 females and 167 males, were included in the study between 2023 and 2024. Demographic data and clinical parameters of COPD patients admitted to intensive care due to hypercapnic respiratory failure and treated with noninvasive ventilation (NIV) were compared between genders. : The number of male patients was higher than female patients, while the mean age of female patients was higher than that of males. The body mass index (BMI), morbid obesity, atrial fibrillation, renal disease, heart failure, hypertension, hypothyroidism, the Charlson Comorbidity Index (CCI), and the cardiothoracic ratio were found to be significantly higher in female patients. Emphysema and steroid use in treatment were more common in male patients. In laboratory analyses conducted at the time of admission, the average D-dimer and brain natriuretic peptide (BNP) levels were higher in female patients. The mean arterial carbon dioxide pressure (PaCO) level assessed prior to discharge was also higher in female patients. : Heart failure and risk factors that may lead to heart failure are more prominent in female COPD patients with type 2 respiratory failure. Despite the lower number of female patients compared to males, the significantly higher comorbidity burden in females, as per CCI scores, suggests that medical processes may be more challenging to manage in females. We believe that these findings will contribute to clinical practice and provide clinicians with insights for patient management.
通过识别因Ⅱ型呼吸衰竭在重症监护病房接受监测的慢性阻塞性肺疾病(COPD)患者中的性别差异,为临床实践提供参考。本研究计划为一项前瞻性、观察性横断面调查。2023年至2024年期间,共有258例患者纳入研究,其中女性91例,男性167例。对因高碳酸血症性呼吸衰竭入住重症监护病房并接受无创通气(NIV)治疗的COPD患者的人口统计学数据和临床参数进行了性别间比较。结果显示:男性患者数量多于女性患者,而女性患者的平均年龄高于男性。女性患者的体重指数(BMI)、病态肥胖、心房颤动、肾病、心力衰竭、高血压、甲状腺功能减退、查尔森合并症指数(CCI)和心胸比均显著更高。男性患者肺气肿和治疗中使用类固醇更为常见。入院时进行的实验室分析中,女性患者的平均D-二聚体和脑钠肽(BNP)水平更高。出院前评估的平均动脉二氧化碳分压(PaCO)水平女性患者也更高。结论:在Ⅱ型呼吸衰竭的女性COPD患者中,心力衰竭和可能导致心力衰竭的危险因素更为突出。尽管女性患者数量少于男性,但根据CCI评分,女性患者合并症负担显著更高,这表明女性患者的医疗过程管理可能更具挑战性。我们相信这些发现将有助于临床实践,并为临床医生进行患者管理提供参考。