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Gender differences in emergency department patients with chronic obstructive pulmonary disease exacerbation.
Acad Emerg Med 2005; 12(12):1173-9AE

Abstract

OBJECTIVES

Although more men are diagnosed as having chronic obstructive pulmonary disease (COPD), its prevalence is increasing among women. Little is known about gender differences in exacerbations of COPD. The objective of this study was to determine if acute presentation, management, and outcomes differ among men and women seeking care in the emergency department (ED) for exacerbation of COPD.

METHODS

This was a secondary analysis of a prospective cohort study of ED patients aged 55 years or older who presented with an exacerbation of COPD. Subjects underwent structured interviews in the ED and two weeks later.

RESULTS

The cohort consisted of 397 subjects with COPD, of whom 52% were women. Self-report of COPD only tended to be more common among men (61% of men vs. 52% of women), while mixed COPD/asthma tended to be more common among women (39% vs. 48%; p = 0.10). Despite reporting similar chronic symptom severity, women were less likely than men to use anticholinergic agents before their ED visit (59% vs. 69%; p = 0.04). During the exacerbation, women initiated less home therapy and were less likely to seek emergency care within the first 24 hours of symptom onset (25% vs. 36%; p = 0.01). Although ED care and disposition were similar, post-ED outcomes differed. At two-week follow-up, men were more likely to report an ongoing exacerbation (42% vs. 31%; p = 0.03).

CONCLUSIONS

Men and women who present to the ED for treatment of an exacerbation of COPD have substantial differences in long-term medication use, self-treatment during exacerbation, delay in emergency care, and post-ED outcomes. Further studies are warranted to confirm and explain these gender-related differences.

Authors+Show Affiliations

Department of Emergency Medicine, MetroHealth Medical Center, Case Western Reserve University, Cleveland, OH 44109, USA. rcydulka@metrohealth.orgNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

16282511

Citation

Cydulka, Rita K., et al. "Gender Differences in Emergency Department Patients With Chronic Obstructive Pulmonary Disease Exacerbation." Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine, vol. 12, no. 12, 2005, pp. 1173-9.
Cydulka RK, Rowe BH, Clark S, et al. Gender differences in emergency department patients with chronic obstructive pulmonary disease exacerbation. Acad Emerg Med. 2005;12(12):1173-9.
Cydulka, R. K., Rowe, B. H., Clark, S., Emerman, C. L., Rimm, A. R., & Camargo, C. A. (2005). Gender differences in emergency department patients with chronic obstructive pulmonary disease exacerbation. Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine, 12(12), pp. 1173-9.
Cydulka RK, et al. Gender Differences in Emergency Department Patients With Chronic Obstructive Pulmonary Disease Exacerbation. Acad Emerg Med. 2005;12(12):1173-9. PubMed PMID: 16282511.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Gender differences in emergency department patients with chronic obstructive pulmonary disease exacerbation. AU - Cydulka,Rita K, AU - Rowe,Brian H, AU - Clark,Sunday, AU - Emerman,Charles L, AU - Rimm,Alfred R, AU - Camargo,Carlos A,Jr Y1 - 2005/11/10/ PY - 2005/11/12/pubmed PY - 2006/4/6/medline PY - 2005/11/12/entrez SP - 1173 EP - 9 JF - Academic emergency medicine : official journal of the Society for Academic Emergency Medicine JO - Acad Emerg Med VL - 12 IS - 12 N2 - OBJECTIVES: Although more men are diagnosed as having chronic obstructive pulmonary disease (COPD), its prevalence is increasing among women. Little is known about gender differences in exacerbations of COPD. The objective of this study was to determine if acute presentation, management, and outcomes differ among men and women seeking care in the emergency department (ED) for exacerbation of COPD. METHODS: This was a secondary analysis of a prospective cohort study of ED patients aged 55 years or older who presented with an exacerbation of COPD. Subjects underwent structured interviews in the ED and two weeks later. RESULTS: The cohort consisted of 397 subjects with COPD, of whom 52% were women. Self-report of COPD only tended to be more common among men (61% of men vs. 52% of women), while mixed COPD/asthma tended to be more common among women (39% vs. 48%; p = 0.10). Despite reporting similar chronic symptom severity, women were less likely than men to use anticholinergic agents before their ED visit (59% vs. 69%; p = 0.04). During the exacerbation, women initiated less home therapy and were less likely to seek emergency care within the first 24 hours of symptom onset (25% vs. 36%; p = 0.01). Although ED care and disposition were similar, post-ED outcomes differed. At two-week follow-up, men were more likely to report an ongoing exacerbation (42% vs. 31%; p = 0.03). CONCLUSIONS: Men and women who present to the ED for treatment of an exacerbation of COPD have substantial differences in long-term medication use, self-treatment during exacerbation, delay in emergency care, and post-ED outcomes. Further studies are warranted to confirm and explain these gender-related differences. SN - 1553-2712 UR - https://www.unboundmedicine.com/medline/citation/16282511/Gender_differences_in_emergency_department_patients_with_chronic_obstructive_pulmonary_disease_exacerbation_ L2 - https://onlinelibrary.wiley.com/resolve/openurl?genre=article&sid=nlm:pubmed&issn=1069-6563&date=2005&volume=12&issue=12&spage=1173 DB - PRIME DP - Unbound Medicine ER -