TY - JOUR
T1 - Differences in Clinical Characteristics and Outcomes Between Men and Women With Idiopathic Pulmonary Fibrosis
T2 - A Multicenter Retrospective Cohort Study
AU - Zaman, Tanzira
AU - Moua, Teng
AU - Vittinghoff, Eric
AU - Ryu, Jay H.
AU - Collard, Harold R.
AU - Lee, Joyce S.
N1 - Funding Information:
FUNDING/SUPPORT: This study was funded by the National Institutes of Health/National Heart, Lung, and Blood Institute [Grants T32 HL007085 to T. Zaman, K23 HL138131 to J. S. Lee].
Funding Information:
FUNDING/SUPPORT: This study was funded by the National Institutes of Health / National Heart, Lung, and Blood Institute [Grants T32 HL007085 to T. Zaman, K23 HL138131 to J. S. Lee].
Publisher Copyright:
© 2020 American College of Chest Physicians
PY - 2020/7
Y1 - 2020/7
N2 - Background: Idiopathic pulmonary fibrosis (IPF) is a disease with a male predominance. Prior data suggest that male sex is associated with disease progression and survival. The basis for this sex difference is unknown. Research Question: Are there differences in clinical disease characteristics and outcomes between men and women with IPF? Study Design and Methods: Two tertiary care center IPF cohorts were pooled to analyze sex differences in outcomes of time to lung transplantation or death. Predictors of outcome that were analyzed included age, FVC % predicted, diffusion capacity for carbon monoxide (DLCO) % predicted, BMI, smoking history, and respiratory variables of cough, phlegm, and need for supplemental oxygen. The associations of these factors with mortality were estimated by sex and then compared using tests for interaction. Results: There were a total of 1,263 patients in the pooled cohort with follow-up data; approximately 71% of the patients were men. Male sex was independently associated with higher risk for death or lung transplantation after adjusting for age, FVC % predicted, and DLCO % predicted (hazard ratio for men, 1.4; 95% CI, 1.2-1.7; P < .001). Older age, lower DLCO % predicted, and presence of cough or phlegm were negatively associated with transplant-free survival in men but not in women, but only the association for cough differed statistically by sex (interaction P = .007). Interpretation: Male sex is associated with worse transplant-free survival in IPF. Cough may be a sex-specific predictor of survival in this population.
AB - Background: Idiopathic pulmonary fibrosis (IPF) is a disease with a male predominance. Prior data suggest that male sex is associated with disease progression and survival. The basis for this sex difference is unknown. Research Question: Are there differences in clinical disease characteristics and outcomes between men and women with IPF? Study Design and Methods: Two tertiary care center IPF cohorts were pooled to analyze sex differences in outcomes of time to lung transplantation or death. Predictors of outcome that were analyzed included age, FVC % predicted, diffusion capacity for carbon monoxide (DLCO) % predicted, BMI, smoking history, and respiratory variables of cough, phlegm, and need for supplemental oxygen. The associations of these factors with mortality were estimated by sex and then compared using tests for interaction. Results: There were a total of 1,263 patients in the pooled cohort with follow-up data; approximately 71% of the patients were men. Male sex was independently associated with higher risk for death or lung transplantation after adjusting for age, FVC % predicted, and DLCO % predicted (hazard ratio for men, 1.4; 95% CI, 1.2-1.7; P < .001). Older age, lower DLCO % predicted, and presence of cough or phlegm were negatively associated with transplant-free survival in men but not in women, but only the association for cough differed statistically by sex (interaction P = .007). Interpretation: Male sex is associated with worse transplant-free survival in IPF. Cough may be a sex-specific predictor of survival in this population.
KW - idiopathic pulmonary fibrosis
KW - interstitial lung disease
KW - sex
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U2 - 10.1016/j.chest.2020.02.009
DO - 10.1016/j.chest.2020.02.009
M3 - Article
C2 - 32084394
AN - SCOPUS:85086769933
SN - 0012-3692
VL - 158
SP - 245
EP - 251
JO - Diseases of the chest
JF - Diseases of the chest
IS - 1
ER -