Comorbidity and sex-related differences in mortality in oxygen-dependent chronic obstructive pulmonary disease.
Comorbidity and sex-related differences in mortality in oxygen-dependent chronic obstructive pulmonary disease.
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DOI：
10.1371/journal.pone.0035806
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发表时间：
2012
期刊：
影响因子：
3.7
通讯作者：
Ström KE
中科院分区：
文献类型：
--
作者：
Ekström MP;Jogréus C;Ström KE
目前尚不清楚为什么男性和女性在氧依赖性慢性阻塞性肺病 (COPD) 中的生存率存在差异。本研究评估了男性和女性之间合并症的差异，并检验了合并症导致氧依赖性慢性阻塞性肺病死亡率性别相关差异的假设。 1992 年至 2008 年间，瑞典针对慢性阻塞性肺病开始长期氧疗 (LTOT) 的 50 岁或以上患者进行的全国前瞻性研究。合并症信息来自瑞典医院出院登记处。使用逻辑回归估计合并症的性别相关差异，并调整年龄、吸烟状况和纳入年份。使用 Cox 回归评估合并症对总体死亡率的影响以及合并症与性别之间的相互作用，调整年龄、性别、呼吸空气 PaO2、FEV1、吸烟史和纳入年份。研究期间总共纳入了 8,712 名患者（55% 为女性），其中 6,729 名患者死亡。没有患者失访。与女性相比，男性心律失常、癌症、缺血性心脏病和肾功能衰竭的发病率明显更高，而高血压、精神障碍、骨质疏松症和类风湿性关节炎的发病率则明显更高（所有比值比 P<0.05）。合并症是死亡率的独立预测因素，并且对性别的影响相似。女性的死亡率较低，即使在调整合并症后，死亡率仍保持不变；风险比 0.73（95% 置信区间，0.68–0.77；P<0.001）。男性和女性的合并症不同，但不能解释氧依赖性慢性阻塞性肺病死亡率的性别相关差异。
It is not known why survival differs between men and women in oxygen-dependent chronic obstructive pulmonary disease (COPD). The present study evaluates differences in comorbidity between men and women, and tests the hypothesis that comorbidity contributes to sex-related differences in mortality in oxygen-dependent COPD. National prospective study of patients aged 50 years or older, starting long-term oxygen therapy (LTOT) for COPD in Sweden between 1992 and 2008. Comorbidities were obtained from the Swedish Hospital Discharge Register. Sex-related differences in comorbidity were estimated using logistic regression, adjusting for age, smoking status and year of inclusion. The effect of comorbidity on overall mortality and the interaction between comorbidity and sex were evaluated using Cox regression, adjusting for age, sex, PaO2 breathing air, FEV1, smoking history and year of inclusion. In total, 8,712 patients (55% women) were included and 6,729 patients died during the study period. No patient was lost to follow-up. Compared with women, men had significantly more arrhythmia, cancer, ischemic heart disease and renal failure, and less hypertension, mental disorders, osteoporosis and rheumatoid arthritis (P<0.05 for all odds ratios). Comorbidity was an independent predictor of mortality, and the effect was similar for the sexes. Women had lower mortality, which remained unchanged even after adjusting for comorbidity; hazard ratio 0.73 (95% confidence interval, 0.68–0.77; P<0.001). Comorbidity is different in men and women, but does not explain the sex-related difference in mortality in oxygen-dependent COPD.
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影响因子：
13.6
作者：
Andersson, T;Alfredsson, L;Ahlbom, A
通讯作者：
Ahlbom, A
影响因子：
4.3
作者：
Franklin, Karl A.;Gustafson, Torbjorn;Strom, Kerstin
通讯作者：
Strom, Kerstin
DOI：
10.1164/rccm.201010-1704oc
发表时间：
2011-04-15
影响因子：
24.7
作者：
Ekstrom, Magnus P.;Wagner, Philippe;Strom, Kerstin E.
通讯作者：
Strom, Kerstin E.
影响因子：
9.6
作者：
Almagro, P;Calbo, E;Garau, J
通讯作者：
Garau, J
影响因子：
9.6
作者：
de Torres, JP;Casanova, C;Celli, BR
通讯作者：
Celli, BR