SEX-DIFFERENCES IN MORTALITY OF PEOPLE WHO VISITED EMERGENCY ROOMS FOR ASTHMA AND CHRONIC OBSTRUCTIVE PULMONARY-DISEASE

We assess the sex differences in mortality in a population-based cohor t of those Barcelona residents older than 14 yr of age who received em ergency room services (ERS) for either chronic obstructive pulmonary d isease (COPD) or asthma, during the period from 1985 to 1989. Vital st atus was followed to the end of 1995. A total of 15,517 individuals, 9 ,918 males and 5,599 females were included in the study. Asthma was di agnosed in 16% of males and 53% of females. Overall, 50% of males and 30% of females died during the follow-up period. The mortality rates i n both males and females who visited emergency rooms for COPD or asthm a were significantly higher than the expected rates in the general pop ulation. These relative increases in the mortality rates were signific antly higher in females than in males for both causes of death, COPD ( age-adjusted female/male ratio = 2.39), and asthma (ratio = 3.95). How ever, survival was better in females than males among individuals in t he study. The higher fatality in males than females was observed for a ll causes of death, all respiratory causes, and COPD (risk ratio among patients with COPD = 0.42, 0.29-0.59, and among patients with asthma = 0.11, 0.02-0.60), but not for asthma. Mortality for asthma was highe r in females with a diagnosis of COPD (2.79, 1.52-5.13), but it was no t different among individuals in whom asthma was diagnosed (1.02, 0.56 -1.87). Greater severity of COPD in males than in females could explai n a higher risk of dying for all respiratory causes and COPD in males. The increased risk of asthma death in females may be due to problems of coding the term ''asthma'' in death certificates. The higher rates in females than in males when comparing with the general population, m ay be an expression of a greater similarity in risk factors, such as s moking, in our population than in males and females of the general pop ulation.