Diferencias clínicas y pronósticas de la enfermedad pulmonar obstructiva crónica en mujeres derivadas a rehabilitación respiratoria: una visión con enfoque de género

Q3 Medicine

Rehabilitacion Pub Date : 2024-10-01 DOI:10.1016/j.rh.2024.100871

C. Acuña-Pardo , V. Dávalos-Yerovi , C. Ramírez-Fuentes , Y.G. Curbelo-Peña , C. Rodriguez-Hernandez , M. Tejero-Sánchez

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引用次数: 0

Abstract

Introduction

Respiratory rehabilitation programmes improve clinical and functional outcomes in patients with chronic obstructive pulmonary disease (COPD), but it is unknown whether their impact differs between men and women.

Objectives

To assess possible sex differences in semiology, comorbidities and prognosis in COPD patients referred to respiratory rehabilitation.

Material and methods

Post-hoc analysis of a prospective cohort of COPD patients referred to rehabilitation from December 2012 to January 2020. Mortality and hospitalisations adjusted for sex, age, severity and body mass index were assessed. Statistical tests used: Chi-square, Student's t, linear regression model and Kaplan-Meier survival curve.

Results

Of 173 patients (age 66.6 years; 70% severe COPD), there were 36 (20.8%) women. Compared to men, women were younger (–4.8 years [95% CI 1.5-8.0; P=.004]) and reported greater dyspnoea on the modified Medical Research Council scale (+0.4 points [95% CI 0.1-0.9; P=.026]). During follow-up, 21 (12.2%) patients died and 79 (45.9%) required ≥2 hospital admissions, with no significant differences between sexes. Despite having lower comorbidity (–0.8 Charlson index points [95% CI –1.3 to –0.3, P=.004]), women had a higher prevalence of depression (53.6% vs. 22.7%, P=.001) and anxiety (37% vs 16.7%, P=.020) than men.

Conclusions

Prognosis in terms of mortality and hospital admissions is not different between men and women. Women have a higher degree of dyspnoea and less comorbidity than men, although the prevalence of anxiety and depression is higher.

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[转诊至呼吸康复中心的女性慢性阻塞性肺病的临床和预后差异：性别观点]。

简介：呼吸康复计划可改善慢性阻塞性肺病（COPD）患者的临床和功能预后，但其对男性和女性的影响是否存在差异尚不得而知：呼吸康复计划可改善慢性阻塞性肺病（COPD）患者的临床和功能预后，但其对男性和女性的影响是否存在差异尚不清楚：材料与方法：对前瞻性慢性阻塞性肺病（COPD）患者进行事后分析：对2012年12月至2020年1月期间转诊至康复中心的慢性阻塞性肺病患者进行前瞻性队列事后分析。根据性别、年龄、严重程度和体重指数调整死亡率和住院率。使用的统计检验结果：在 173 名患者（年龄 66.6 岁；70% 患有严重慢性阻塞性肺病）中，有 36 名女性（20.8%）。与男性相比，女性更年轻（-4.8 岁 [95% CI 1.5-8.0；P=.004]），且在改良医学研究委员会量表中报告的呼吸困难程度更高（+0.4 分 [95% CI 0.1-0.9；P=.026]）。在随访期间，21 名患者（12.2%）死亡，79 名患者（45.9%）需要≥2 次入院治疗，男女之间无明显差异。尽管合并症较少（-0.8个Charlson指数点[95% CI -1.3 to -0.3，P=.004]），但女性抑郁症（53.6% vs. 22.7%，P=.001）和焦虑症（37% vs. 16.7%，P=.020）的发病率高于男性：就死亡率和住院率而言，男性和女性的预后并无不同。女性呼吸困难程度较高，合并症较少，但焦虑症和抑郁症的发病率较高。

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来源期刊

Rehabilitacion Medicine-Rehabilitation

CiteScore

0.80

自引率

0.00%

发文量

期刊介绍： La revista que es desde hace más de 40 años la publicación oficial de la Sociedad Española de Rehabilitación y referente de la mayoría de las Sociedades de la Especialidad de los países americanos de habla hispana. Se publican 5 números pluritemáticos al año y uno monográfico sobre un tema del mayor interés y actualidad designado por el consejo de redacción.