Calle Rubio Myriam, Esmaili Soha, Esmaili Iman, Gómez Martín-Caro Lucia, Ayat Ortiz Sofia, Rodríguez Hermosa Juan Luis
Department of Medicine, School of Medicine, Universidad Complutense de Madrid, 28040 Madrid, Spain.
Pulmonology Department, Hospital Clínico San Carlos, C/ Profesor Martín Lagos, s/n, 28003 Madrid, Spain.
J Clin Med. 2025 Sep 4;14(17):6258. doi: 10.3390/jcm14176258.
. Sex-based disparities in chronic obstructive pulmonary disease (COPD) diagnosis remain underexplored, particularly in primary care settings. This study assessed sex differences in clinical burden, diagnostic delay, and missed diagnostic opportunities using conventional and composite metrics. . A cross-sectional analysis was conducted in 166 newly diagnosed COPD patients (76 women, 90 men) from Spanish primary care. Clinical severity, healthcare use, and diagnostic timing were compared using Mann-Whitney and chi-squared tests. Composite indices included the Symptom Intensity Score, Diagnostic Inertia Indices, DOSE Index, and Diagnosis Complexity Score. Multivariable regressions evaluated independent associations. . At diagnosis, women showed a greater clinical and functional burden (FEV % predicted: 50.4% vs. 61.4%, < 0.001; symptom intensity z-score: 0.13 vs. -0.67, < 0.001), higher diagnostic complexity (Diagnosis Complexity Score: 403.5 vs. 272.0, < 0.001), and longer diagnostic delay (median: 133.0 vs. 66.5 days, < 0.001). Stratified and composite analyses confirmed consistent sex-based asymmetries. In adjusted models, being female independently predicted a longer diagnostic delay (β = 0.888, = 0.005), but was not significantly associated with the burden of missed diagnostic opportunities (MDOs) (β = 0.112, = 0.395). . Women with newly diagnosed COPD experience greater symptom burden and longer diagnostic delays. Composite metrics may improve the identification of diagnostic disparities in routine clinical settings.
慢性阻塞性肺疾病（COPD）诊断中基于性别的差异仍未得到充分研究，尤其是在初级保健环境中。本研究使用传统指标和综合指标评估了临床负担、诊断延迟和诊断机会错失方面的性别差异。
对来自西班牙初级保健机构的166例新诊断的COPD患者（76例女性，90例男性）进行了横断面分析。使用曼-惠特尼检验和卡方检验比较了临床严重程度、医疗保健利用情况和诊断时间。综合指标包括症状强度评分、诊断惰性指数、DOSE指数和诊断复杂性评分。多变量回归评估了独立关联。
在诊断时，女性表现出更大的临床和功能负担（预测FEV%：50.4%对61.4%，P<0.001；症状强度z评分：0.13对-0.67，P<0.001）、更高的诊断复杂性（诊断复杂性评分：403.5对272.0，P<0.001）和更长的诊断延迟（中位数：133.0天对66.5天，P<0.001）。分层分析和综合分析证实了基于性别的一致不对称性。在调整模型中，女性独立预测诊断延迟更长（β = 0.888，P = 0.005），但与诊断机会错失负担（MDOs）无显著关联（β = 0.112，P = 0.395）。
新诊断为COPD的女性经历更大的症状负担和更长的诊断延迟。综合指标可能有助于在常规临床环境中识别诊断差异。
