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. 2024 Mar 11;24(1):125.
doi: 10.1186/s12890-024-02948-4.

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

Jiarui Zhang #  1 , Qun Yi #  1   2 , Chen Zhou  3 , Yuanming Luo  4 , Hailong Wei  5 , Huiqing Ge  6 , Huiguo Liu  7 , Jianchu Zhang  8 , Xianhua Li  9 , Xiufang Xie  9 , Pinhua Pan  10 , Mengqiu Yi  11 , Lina Cheng  11 , Hui Zhou  12 , Liang Liu  12 , Adila Aili  1 , Yu Liu  1 , Lige Peng  1 , Jiaqi Pu  1 , Haixia Zhou  13
Affiliations

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

Jiarui Zhang et al. BMC Pulm Med. .

Abstract

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 .

Keywords: Acute exacerbation of chronic obstructive pulmonary disease; Characteristics; In-hospital mortality; Sex differences; Treatments.

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Conflict of interest statement

The authors declare that the research had no conflicts of interest.

Figures

Fig. 1
Fig. 1
Flow chart of the study
Fig. 2
Fig. 2
The in-hospital mortality in the overall cohort and the subgroup of smokers according to sex
Fig. 3
Fig. 3
The incidence of ICU admission at discharge in the overall cohort and the subgroup of smokers according to sex
Fig. 4
Fig. 4
(A) Survival curve of the overall cohort according to sex. (B) Survival curve of the subgroup of smokers according to sex
See this image and copyright information in PMC

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