Predictors of COPD symptoms: does the sex of the patient matter?

Watson, Louise

doi:10.1183/09031936.06.00055805

Cited by 43 publications

(31 citation statements)

References 24 publications

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“…They may, therefore, be more likely to be classified as having an exacerbation. However, there are also data indicating that females are at higher risk of being hospitalised for exacerbations [37], which is unlikely to be due solely to differential symptom reporting. A higher MRC dyspnoea grade may identify patients more likely to receive exacerbation treatment when they present with worsening symptoms.…”

Section: Mortalitymentioning

confidence: 99%

Seasonality and determinants of moderate and severe COPD exacerbations in the TORCH study

Jenkins

Celli²,

Anderson³

et al. 2011

Eur Respir J

198

152

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We investigated the impact of season relative to other determinants of chronic obstructive pulmonary disease (COPD) exacerbation frequency in a long-term international study of patients with forced expiratory volume in 1 s (FEV1) ,60% predicted. COPD exacerbations were defined by worsening symptoms requiring systemic corticosteroids and/or antibiotics (moderate) or hospital admission (severe). Seasonality effect was calculated as the proportion of patients experiencing an exacerbation each month.Exacerbations in the northern and southern regions showed an almost two-fold increase in the winter months. No seasonal pattern occurred in the tropics. Overall, 38% of exacerbations were treated with antibiotics only, 19% with systemic corticosteroids only and 43% with both, while 20% required hospital admission irrespective of the season. Exacerbation frequency was associated with older age, lower body mass index, lower FEV1 % pred and history of prior exacerbations. Females and patients with worse baseline breathlessness, assessed using the Medical Research Council (MRC) dyspnoea scale, exacerbated more often (rate ratio (RR) for male versus female 0.7, 95% CI 0.7-0.8 (p,0.001); RR for MRC dyspnoea score 3 versus 1 and 2 combined 1.1, 95% CI 1.1-1.2 (p,0.001)). The effect of season was independent of these risk factors.COPD exacerbations and hospitalisations were more frequent in winter.

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Section: Mortalitymentioning

confidence: 99%

Seasonality and determinants of moderate and severe COPD exacerbations in the TORCH study

Jenkins

Celli²,

Anderson³

et al. 2011

Eur Respir J

198

152

View full text Add to dashboard Cite

show abstract

“…17 In developing countries where biomass fuels are used to heat homes and cook meals, women develop COPD more frequently from indoor air pollution than from cigarette exposure. 15,[18][19][20][21] Exposure to biomass fuels, occupational exposures, and remodelled asthma are important causal agents in the estimated 15% of individuals with COPD who have never smoked. 22,23 Differences in lung growth rates between males and females combined with early age of smoking initiation 24,25 and sex-specific smoking behaviours 26,27 further enhance the susceptibility of women to tobacco smoke.…”

Section: Susceptibilitymentioning

confidence: 99%

Reconsidering sex-based stereotypes of COPD

Ohar

Fromer

Donohue

2011

Primary Care Respiratory Journal

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Chronic obstructive pulmonary disease (COPD) has historically been considered a disease of older, white, male smokers, as illustrated in Frank Netter's classic images of the 'pink puffer' and 'blue bloater'. However, women may be more susceptible to COPD than men, and the disease course may be reflective of that increased susceptibility. From a review of epidemiological data of COPD, we found differences in the way men and women present with COPD symptoms, a bias in the way COPD symptoms are treated in men and women, and differences in susceptibility to airway obstruction based on age, sex, and smoking history. These data show that classic stereotypes of COPD -including male predominance -should be abandoned, and that there are not two but multiple COPD phenotypes, which are characterised by differences between women and men in susceptibility, symptoms, and disease progression. These differences impact on physician perception. Although further research into this concept is needed, the differences we found should prompt, in the short term, changes in the way (and in whom) COPD is evaluated, diagnosed, and treated; in the long term, these differences should prompt research into the prognosis of COPD based on sex differences.

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“…The EUROSCOPE study 106 , which included 816 men and 312 women with COPD, showed that respiratory symptoms (wheeze, dyspnoea, cough and phlegm) were associated with lung function in men only. Another populationbased study found that women with or without COPD reported similar health status, whereas men with COPD reported significantly worse health status than men without COPD 139 .…”

Section: Factors Associated With Low Physical Activitymentioning

confidence: 99%

The relationship between physical function and experience of fatigue in patients with chronic obstructive pulmonary disease

Tödt¹

2014

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Background Chronic Obstructive Pulmonary Disease (COPD) is increasing throughout the world and most rapidly among women. COPD is characterized by a progressive loss of physical functions. The reason for this is multi-factorial and include not only lung related deficiencies but also several systemic consequences and symptoms of which several are potential restrictors of physical function. The relationship between physical function and symptoms are not clear, especially not among women with COPD. Aim The overall aim of this thesis was to illuminate the relationship between two dimensions of physical function (physical activity and physical capacity) and experience of fatigue. The specific aims were to explore factors associated with low physical activity and to examine experience of fatigue and its relationship to physical capacity and disease severity in men and women with COPD. Methods A cross-sectional study was conducted including 121 patients (67 women) with stable COPD and mean age of 67 (+/-7) years. Physical activity was measured with the International Physical Activity Questionnaire short form. Physical capacity included assessment of lung function (dynamic spirometry), exercise capacity (the 6-minute walk distance [perceived dyspnoea and leg fatigue in connection to the test]) and muscle strength (the Timed Stands Test and grip strength). Fatigue was assessed with structured questions covering the frequency, duration and severity of fatigue the previous month and patients were categorized as those with no fatigue, moderate fatigue or severe fatigue. Data about other symptoms (dyspnoea, anxiety and depression), symptom burden (Memorial Symptom Assessment Scale), fat and fat free mass (bio-impedance analysis) and smoking history was collected. Results Forty-two percent of the patients reported a low physical activity level. A majority of the patients reported experience of fatigue the previous month, 52% moderate fatigue and 25% severe fatigue. Low physical activity was associated with severe fatigue, worse exercise capacity and a higher amount of smoking. There were no differences in experience of fatigue between men and women. Men with fatigue had worse physical capacity and disease severity compared to men without fatigue. Women with fatigue had comparable physical capacity and disease severity to women without fatigue except for a higher perceived leg fatigue after the exercise capacity test. Multiple logistic regression analysis showed that exercise capacity and disease severity were associated with fatigue in both men and women but in women, leg fatigue was also strongly associated with the presence of fatigue. Conclusions Severe fatigue, worse exercise capacity and a higher amount of smoking were independently associated with low PA. This result suggests that patients with severe fatigue might need specific strategies to become more physically active. Presence of fatigue was associated with exercise capacity and disease severity in both men and women. In addition, in women leg fatigue was strongly a...

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Predictors of COPD symptoms: does the sex of the patient matter?

Cited by 43 publications

References 24 publications

Seasonality and determinants of moderate and severe COPD exacerbations in the TORCH study

Seasonality and determinants of moderate and severe COPD exacerbations in the TORCH study

Reconsidering sex-based stereotypes of COPD

The relationship between physical function and experience of fatigue in patients with chronic obstructive pulmonary disease

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