Factores relacionados con el mayor porcentaje de ingresos por asma en mujeres. Estudio FRIAM / Factors Related With the Higher Percentage of Hospitalizations Due to Asthma Amongst Women: the FRIAM Study

RESUMEN

Introducción: Las mujeres ingresan por exacerbaciones de asma con mayor porcentaje que los varones, sin que se conozcan claramente los motivos. El objetivo del estudio es explorar las posibles causas que expliquen este hecho. Pacientes y métodos: Estudio prospectivo multicéntrico en pacientes ingresados por asma durante 2 años en servicios de neumología. Mediante cuestionario se recogieron características demográficas, variables previas al ingreso y durante el mismo que incluían adherencia, ansiedad-depresión, hiperventilación, y control del asma. Resultados: Se recogieron datos de 183 ingresos 115 mujeres (62,84%). Las mujeres eran de mayor edad (52,4±18,3/43,4±18,7; p=0,02); había mayor porcentaje con prescripción de corticosteroides inhalados (63,2/47,1%; p=0,03) y síndrome de hiperventilación (57,3/35,9%; p=0,02), y una estancia media mayor (7,3±3,4/5,9±3,6; p=0,02). El porcentaje de fumadoras era menor (21,2/38,8%; p=0,01), y el FEV1 al ingreso era más bajo (58,2%±15,9/67,5%±17,4; p=0,03).En el rango de 40 a 60 años se demostró una asociación entre ser mujer y la variable ingresos previos. De forma independiente, también se asociaron el sexo y la obesidad, con un OR de 16,1 (IC 95%, 1,6-156,7) y de 4,8 (IC 95%, 1,06-22), respectivamente. Conclusiones: El porcentaje de ingresos por asma fue mayor en mujeres. Ser mujer entre 40 y 60 años se asocia con ingresos previos y constituye un factor de riesgo para ingreso por asma, en el que la hipótesis hormonal durante el climaterio podría explicar parte de los hechos. La poliposis y la obesidad son factores de riesgo, independientemente del sexo(AU)

ABSTRACT

Introduction: The reason why there is a higher hospitalization rate due to asthma exacerbations amongst women is unclear. The objective of this study is to explore the possible causes that may explain this fact. Methods: A multi-center, prospective study including asthma patients hospitalized in the pulmonary medicine departments during a two-year period. By means of a questionnaire, the following data were collected demographic characteristics and treatment compliance, anxiety-depression, hyperventilation and asthma control, both prior to and during the hospitalization. Results:183 patients were included, 115 (62.84%) of whom were women. The women were older (52.4±18.3/43.4±18.7; P=.02), were more frequently prescribed inhaled corticosteroids (63.2%/47.1%; P=.03) and had a higher rate of hyperventilation syndrome (57.3/35.9; P=.02) and a longer mean hospital stay (7.3±3.4/5.9±3.6; P=.02). The percentage of smokers among the women was lower (21.2%/38.8%; p=0.01) and the FEV1 was lower at admittance (58.2% ±15.9/67.5%±17.4; P=.03).In the 40 to 60-year-old age range, an association was demonstrated between being female and the «previous hospitalizations» variable (OR, 16.1; 95% CI, 1.6-156.7); sex and obesity were also independently associated (OR, 4.8; 95% CI, 1.06-22).Conclusions: In this cohort, the rate of hospitalization for asthma was higher in women than in men. Being a woman between the ages of 40 and 60 is associated with previous hospitalizations and is a risk factor for asthma-related hospitalization. This situation could partially be explained by the hormonal changes during menopause, where polyposis and obesity are independent risk factors(AU)