Gender Differences in Outcomes of Patients with Cystic Fibrosis
| Autor: | Raksha Jain, Daniel B. Rosenbluth, Alan C. Elliott, Deepa Raghavan, Cayce L. Harness-Brumley |
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| Jazyk: | angličtina |
| Rok vydání: | 2014 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent Cystic Fibrosis Population Kaplan-Meier Estimate Cystic fibrosis Young Adult Life Expectancy Sex Factors Risk Factors Internal medicine medicine Humans Registries Young adult Age of Onset Intensive care medicine education Child Survival rate Respiratory Tract Infections Proportional Hazards Models Retrospective Studies education.field_of_study Respiratory tract infections Bacteria Proportional hazards model business.industry Incidence (epidemiology) Incidence Retrospective cohort study General Medicine Original Articles Middle Aged medicine.disease United States Survival Rate Treatment Outcome Socioeconomic Factors Female business |
| Popis: | Cystic fibrosis (CF) is a common life-shortening genetic disease in which women have been described to have worse outcomes than males, particularly in response to respiratory infections with Pseudomonas aeruginosa. However, as advancements in therapies have improved life expectancy, this gender disparity has been challenged. The objective of this study is to examine whether a gender-based survival difference still exists in this population and determine the impact of common CF respiratory infections on outcomes in males versus females with CF.We conducted a retrospective cohort analysis of 32,766 patients from the United States Cystic Fibrosis Foundation Patient Registry over a 13-year period. Kaplan-Meier and Cox proportional hazards models were used to compare overall mortality and pathogen based survival rates in males and females.Females demonstrated a decreased median life expectancy (36.0 years; 95% confidence interval [CI] 35.0-37.3) compared with men (38.7 years; 95% CI 37.8-39.6; p0.001). Female gender proved to be a significant risk factor for death (hazard ratio 2.22, 95% CI 1.79-2.77), despite accounting for variables known to influence CF mortality. Women were also found to become colonized earlier with several bacteria and to have worse outcomes with common CF pathogens.CF women continue to have a shortened life expectancy relative to men despite accounting for key CF-related comorbidities. Women also become colonized with certain common CF pathogens earlier than men and show a decreased life expectancy in the setting of respiratory infections. Explanations for this gender disparity are only beginning to be unraveled and further investigation into mechanisms is needed to help develop therapies that may narrow this gender gap. |
| Databáze: | OpenAIRE |
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