In recent years, COPD has become an increasing problem among women. In the US, the absolute numbers of COPD cases, hospitalizations, and deaths among women have exceeded those among men. Many studies have suggested that COPD may be under-diagnosed among women. Obesity and smoking are independently associated with COPD, both of which have increased significantly in inner city areas. We conducted this study to better understand gender-based differences among patients with COPD at our institution that predominantly serves inner-city New-Yorkers.
Patients with COPD who underwent pulmonary function tests(PFTs) from 2002 to 2008 were included in a case control study among men and women. COPD diagnosis and PFT abnormalities was obtained from the Pulmonary specialist's notes after the PFT was performed. Logistic regression was used to estimate odds ratio(OR) and confidence interval was 95%CI with p value significant at <0.05.
Clinical characteristics across gender is shown in Table-1. Among 679 patients included in the study, 63.5% were women while 36.5% were men. Smoking history was present 39% of women and 59.3% of men. Patients with unknown smoking history were excluded from the regression analysis, and the remaining 570 patients were analyzed. Women were significantly increased odds of BMI > 25(OR 2.28, 95% CI 1.4 o 3.7, p < 0.001) and lower odds of being smokers(OR 0.39, 95% CI 0.27 to 0.57, p < 0.000). There were no significant differences with respect to age, ethnicity or abnormal PFTs.
Women were significantly at higher odds of being diagnosed with COPD at our pulmonary clinic. This is contrary to previous literature that suggests that COPD is under-diagnosed among women. Increased presence of COPD was noted despite lower smoking exposure among women, and this is may due to the influence of obesity on respiratory function.
This study offers more insight into understanding COPD in women at a time when the obesity epidemic poses a growing challenge to clinicians caring for patients in inner city areas.
Raghu Loganathan, No Financial Disclosure Information; No Product/Research Disclosure Information