Chest
Original ResearchCOPDIncreased Relative Mortality in Women With Severe Oxygen-Dependent COPD
Section snippets
Materials and Methods
Patients starting LTOT for chronic hypoxia due to COPD in Sweden between January 1, 1987, and December 31, 2004, were included in a National Oxygen Register administered by the Swedish Society of Respiratory Medicine.17, 18, 19 Every center prescribing LTOT in Sweden agreed on the national guidelines from the Swedish Society of Respiratory Medicine, as described elsewhere.9 Patients who started LTOT more than once were excluded. All other patients were followed prospectively, with cause of
Results
A total of 7,646 patients, 4,033 women and 3,613 men, were included in the study after exclusion of 71 patients who had started LTOT more than once. No patient was lost to follow-up. LTOT was withdrawn in 436 (5.7%) patients as a result of improvement in oxygenation (n = 195), poor compliance (n = 36), or for other reasons (n = 205).
Patient characteristics at baseline are shown in Table 1. Women had a slightly lower mean age at the start of LTOT and a slightly higher Paco2 both when breathing
Discussion
A new finding in the present study is that women have significantly higher relative mortality than men, not only concerning all-cause mortality and mortality from respiratory disease, but also from cardiovascular disease and cancer.
Studies of differences in observed survival rates between men and women after initiation of LTOT for COPD have shown contradictory results. Most studies showed higher survival rates for women,5, 6, 7, 9, 13 whereas the study by Machado et al8 found a survival
Acknowledgments
Author contributions: Dr Ekström: contributed to the design of the study and the analysis, interpretation, and presentation of data, drafted the submitted article, and provided final approval of the version to be published.
Dr Franklin: contributed to the analysis and interpretation of data, revised it critically for important scientific content, and provided final approval of the version to be published.
Dr Ström: was responsible for the Swedish Oxygen Register 1987–2007 during the collection of
References (0)
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2017, International Journal of COPD
Funding/Support: The study was supported by grants from the Swedish Heart and Lung Foundation, the Swedish National Board of Health and Welfare, and the Research Council of Blekinge.
Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (www.chestjournal.org/site/misc/reprints.xhtml).