PURPOSE: To assess frequency of overall hospitalizations and those due to COPD (Chronic Obstructive Pulmonary Disease) exacerbations based on office spirometry results in patients with moderately severe COPD.
METHODS: Data were collected retrospectively from the pulmonary function test laboratory at St. Mary’s Medical Center on all office spirometry testing performed between 01/2009 to 01/2010. Patients who were current or ex smokers with an FEV1 < 70%, FEV1/FEV6 < 70 and meeting ATS (American Thoracic Society) standards for acceptable spirometry were included in the study. Of the 544 office spirometry tests performed on all patients during the study period 114 patients (35 women and 79 men) met inclusion study criteria. Hospital records of study patients were reviewed using the electronic medical records system to identify the number of hospitalizations for the same time period based on admission and discharge diagnosis.
RESULTS: There were significantly more hospitalizations of women compared to men, mean of 2.63 versus 1.75 (p=0.02), despite no gender difference in the severity of FEV1/FEV6 ratio between women, mean 56.3 versus men 57.5 (p=0.52). The FEV1/FEV6 closely correlated with the FEV1/FVC ratio (r=0.91). Of the 233 hospital admissions, 56 (24%) were due to COPD exacerbation. Twenty-five women (71.4%) and 31 men (39.2%) (p=0.002) were admitted due to COPD exacerbations. There was no effect of age, weight, and lung function on hospital admissions.
CONCLUSION: Despite higher overall hospitalization rates among women over men, assessment of lung function based on FEV1/FEV6 does not apparently account for this disparity between them. The higher rates of COPD exacerbations in women accounted for their higher total number of hospitalizations.
CLINICAL IMPLICATIONS: The higher overall and COPD related hospitalizations among women compared to men in patients with moderate COPD cannot be explained by the degree of impairment in lung function between the two genders, suggesting that unique features underlie COPD illness in women.
DISCLOSURE: Mumtaz Zaman, No Financial Disclosure Information; No Product/Research Disclosure Information