000148414 001__ 148414
000148414 005__ 20250923084433.0
000148414 0247_ $$2doi$$a10.1016/j.chest.2024.10.002
000148414 0248_ $$2sideral$$a141352
000148414 037__ $$aART-2024-141352
000148414 041__ $$aeng
000148414 100__ $$aNowalk, Nathan C.
000148414 245__ $$aGender Differences in Outcomes of Ambulatory and Hospitalized Patients With Obesity Hypoventilation Syndrome
000148414 260__ $$c2024
000148414 5060_ $$aAccess copy available to the general public$$fUnrestricted
000148414 5203_ $$aBackground
Obesity hypoventilation syndrome (OHS) is associated with high morbidity and mortality. There are few data on whether there are gender differences in outcomes.
Research Question
Do women with OHS experience worse outcomes in ambulatory and hospitalized settings compared to men?
Study Design and Methods
Post hoc analyses were performed on two separate OHS cohorts: (1) stable ambulatory patients from the two Pickwick randomized controlled trials; and (2) hospitalized patients with acute-on-chronic hypercapnic respiratory failure from a retrospective international cohort. We first conducted bivariate analyses of baseline characteristics and therapeutics between genders. Variables of interest from these analyses were then grouped into linear mixed effects models, Cox proportional hazards models, or logistic regression models to assess the association of gender on various clinical outcomes.
Results
The ambulatory prospective cohort included 300 patients (64% self-identified as women), and the hospitalized retrospective cohort included 1,162 patients (58% self-identified as women). For both cohorts, women were significantly older and more obese than men. Compared with men, baseline Paco2 was similar in ambulatory patients but higher in hospitalized women. In the ambulatory cohort, in unadjusted analysis, women had increased risk of emergency department visits. However, gender was not associated with the composite outcome of emergency department visit, hospitalization, or all-cause mortality in the fully adjusted model. In the hospitalized cohort, prescription of positive airway pressure was less prevalent in women at discharge. In unadjusted analysis, hospitalized women had a higher mortality at 3, 6, and 12 months following hospital discharge compared with men. However, after adjusting for age, gender was not associated with mortality.
Interpretation
Our findings indicate that although the diagnosis of OHS is established at a more advanced age in women, gender is not independently associated with worse clinical outcomes after adjusting for age. Future studies are needed to examine gender-related health disparities in diagnosis and treatment of OHS.
000148414 536__ $$9info:eu-repo/grantAgreement/ES/ISCIII PI0540402
000148414 540__ $$9info:eu-repo/semantics/openAccess$$aby-nc-nd$$uhttp://creativecommons.org/licenses/by-nc-nd/3.0/es/
000148414 590__ $$a8.6$$b2024
000148414 592__ $$a1.834$$b2024
000148414 591__ $$aCRITICAL CARE MEDICINE$$b5 / 62 = 0.081$$c2024$$dQ1$$eT1
000148414 593__ $$aCardiology and Cardiovascular Medicine$$c2024$$dQ1
000148414 591__ $$aRESPIRATORY SYSTEM$$b7 / 108 = 0.065$$c2024$$dQ1$$eT1
000148414 593__ $$aPulmonary and Respiratory Medicine$$c2024$$dQ1
000148414 593__ $$aCritical Care and Intensive Care Medicine$$c2024$$dQ1
000148414 655_4 $$ainfo:eu-repo/semantics/article$$vinfo:eu-repo/semantics/acceptedVersion
000148414 700__ $$aMokhlesi, Babak
000148414 700__ $$aNeborak, Julie M.
000148414 700__ $$aMasa Jimenez, Juan Fernando
000148414 700__ $$aBenitez, Ivan
000148414 700__ $$aGomez de Terreros, Francisco J.
000148414 700__ $$aRomero, Auxiliadora
000148414 700__ $$aCaballero-Eraso, Candela
000148414 700__ $$aTroncoso, Maria F.
000148414 700__ $$aGonzález, Mónica
000148414 700__ $$aLópez-Martín, Soledad
000148414 700__ $$0(orcid)0000-0001-9096-2294$$aMarin, José M.$$uUniversidad de Zaragoza
000148414 700__ $$aMartí, Sergi
000148414 700__ $$aDíaz-Cambriles, Trinidad
000148414 700__ $$aChiner, Eusebi
000148414 700__ $$aEgea, Carlos
000148414 700__ $$aUtrabo, Isabel
000148414 700__ $$aBarbe, Ferran
000148414 700__ $$aSánchez-Quiroga, Maria Ángeles
000148414 7102_ $$11007$$2610$$aUniversidad de Zaragoza$$bDpto. Medicina, Psiqu. y Derm.$$cArea Medicina
000148414 773__ $$g167, 1 (2024), 245-248$$pChest$$tChest$$x0012-3692
000148414 8564_ $$s655802$$uhttps://zaguan.unizar.es/record/148414/files/texto_completo.pdf$$yPostprint
000148414 8564_ $$s2152052$$uhttps://zaguan.unizar.es/record/148414/files/texto_completo.jpg?subformat=icon$$xicon$$yPostprint
000148414 909CO $$ooai:zaguan.unizar.es:148414$$particulos$$pdriver
000148414 951__ $$a2025-09-22-14:44:45
000148414 980__ $$aARTICLE