Author:
Trudzinski Franziska C.,Jörres Rudolf A.,Alter Peter,Walter Julia,Watz Henrik,Koch Andrea,John Matthias,Lommatzsch Marek,Vogelmeier Claus F.,Kauczor Hans-Ulrich,Welte Tobias,Behr Jürgen,Tufman Amanda,Bals Robert,Herth Felix J. F.,Kahnert Kathrin,Andreas Stefan,Bals Robert,Behr Jürgen,Kahnert Kathrin,Bewig Burkhard,Buhl Roland,Ewert Ralf,Stubbe Beate,Ficker Joachim H.,Gogol Manfred,Grohé Christian,Hauck Rainer,Held Matthias,Jany Berthold,Henke Markus,Herth Felix,Höffken Gerd,Katus Hugo A.,Kirsten Anne-Marie,Watz Henrik,Koczulla Rembert,Kenn Klaus,Kronsbein Juliane,Kropf-Sanchen Cornelia,Lange Christoph,Zabel Peter,Pfeifer Michael,Randerath Winfried J.,Seeger Werner,Studnicka Michael,Taube Christian,Teschler Helmut,Timmermann Hartmut,Virchow J. Christian,Vogelmeier Claus,Wagner Ulrich,Welte Tobias,Wirtz Hubert,
Abstract
AbstractIn patients with COPD, it has not been comprehensively assessed whether the predictive value of comorbidities for mortality differs between men and women. We therefore aimed to examine sex differences of COPD comorbidities in regard with prognosis by classifying comorbidities into a comorbidome related to extrapulmonary disorders and a pulmorbidome, referring to pulmonary disorders. The study population comprised 1044 women and 1531 men with the diagnosis of COPD from COSYCONET, among them 2175 of GOLD grades 1–4 and 400 at risk. Associations of comorbidities with mortality were studied using Cox regression analysis for men and women separately. During the follow-up (median 3.7 years) 59 women and 159 men died. In men, obesity, hypertension, coronary artery disease, liver cirrhosis, osteoporosis, kidney disease, anaemia and increased heart rate (HR) predict mortality, in women heart failure, hyperuricemia, mental disorders, kidney disease and increased HR (p < 0.05 each). Regarding the pulmorbidome, significant predictors in men were impairment in diffusion capacity and hyperinflation, in women asthma and hyperinflation. Similar results were obtained when repeating the analyses in GOLD 1–4 patients only. Gender differences should be considered in COPD risk assessment for a tailored approach towards the treatment of COPD.Clinical Trial Registration: ClinicalTrials.gov NCT01245933.
Funder
Bundesministerium für Bildung und Forschung
German Centre for Lung Research
Ruprecht-Karls-Universität Heidelberg
Publisher
Springer Science and Business Media LLC