Background

Females with cystic fibrosis (CF) have been shown to have worse pulmonary exacerbation (PEx) related outcomes compared to males. However, it is unknown if sex differences in treatment patterns are contributing to these outcomes. Thus, we sought to explore sex differences in treatment patterns in the Standardized Treatment of Pulmonary Exacerbations (STOP) cohort.

Methods

Data for 220 participants from the STOP cohort were analyzed. Multivariable regression models were used to assess if female sex was associated with duration of treatment with IV antibiotics and inpatient length of stay. Secondary outcomes included antibiotic selection, adjunctive therapies, mean FEV1pp and CFRSD-CRISS respiratory symptom scores at the four study assessments.

Results

In our adjusted model, the average number of IV antibiotic treatment days was 13% higher in females compared to males (IRR 1.13, 95% CI=1.02,1.25; p=0.02). We found no sex differences in inpatient length of stay, number of IV antibiotics, antibiotic selection or initiation of adjunctive therapies. Overall, females had higher CFRSD-CRISS scores at the end of IV therapy indicating worse symptom severity (23.6 for females vs. 18.5 for males, p=0.03).

Conclusions

Despite females having a longer treatment duration, our findings demonstrate that males and females are receiving similar treatments which suggest that the outcome disparities in females with CF may not be due to failure to provide the same level of care. Further research dedicated to sex differences in CF is necessary to understand why clinical outcomes differ between males and females.

中文翻译：

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囊性纤维化肺加重治疗模式的性别差异

背景

与男性相比，患有囊性纤维化 (CF) 的女性的肺恶化 (PEx) 相关结果更差。然而，尚不清楚治疗模式中的性别差异是否会导致这些结果。因此，我们试图探索肺恶化标准化治疗 (STOP) 队列中治疗模式的性别差异。

方法

对来自 STOP 队列的 220 名参与者的数据进行了分析。多变量回归模型用于评估女性是否与静脉抗生素治疗时间和住院时间相关。次要结果包括四项研究评估中的抗生素选择、辅助治疗、平均 FEV1pp 和 CFRSD-CRISS 呼吸道症状评分。

结果

在我们调整后的模型中，女性的平均静脉抗生素治疗天数比男性高 13%（IRR 1.13, 95% CI=1.02,1.25；p=0.02）。我们发现住院时间、静脉注射抗生素数量、抗生素选择或辅助治疗的启动没有性别差异。总体而言，女性在 IV 治疗结束时的 CFRSD-CRISS 评分较高，表明症状严重程度较差（女性为 23.6，男性为 18.5，p=0.03）。

结论

尽管女性的治疗时间较长，但我们的研究结果表明，男性和女性正在接受相似的治疗，这表明女性 CF 的结果差异可能不是由于未能提供相同水平的护理。有必要进一步研究 CF 的性别差异，以了解为什么男性和女性的临床结果不同。