Functional outcomes poorer in women than in men after ischaemic stroke
While in-hospital mortality rate from ischaemic stroke is comparable between males and females, functional outcomes are poorer at discharge and at 6 months in females, a new study has shown.
In the study sample of 4,278 ischaemic stroke patients (mean age 69.9±12.12 years; 41.1 percent female), in-hospital mortality rates were found to be significantly elevated in females compared with males (p<0.01) based on univariate analysis.
However, after adjusting for age, risk factors and severity of stroke, the significant difference in mortality was attenuated (odds ratio [OR], 1.13; 95 percent CI, 0.66 to 1.93).
Univariate analysis also revealed that age >75 years elevated the risk of in-hospital mortality for females only, while stroke severity and increased intracranial pressure raised the risk for both sexes.
Multivariate analysis showed that cardioembolism stroke (OR, 0.35; 0.15 to 0.81; p=0.01) and atrial fibrillation (OR, 2.84; 1.38 to 5.85; p<0.01) significantly increased the risk of in-hospital mortality in females, but not in males.
Good outcomes 6 months after the stroke event were observed in 56.1 percent (n=1,813) of patients. Analysis by gender showed that only 47.4 percent (n=629) of females reported good outcomes as compared to 62.2 percent (n=1,184) of males. The difference reached statistical significance (p<0.01).
Old age (>75 years; p<0.01) significantly correlated with more severe strokes and hypertension (p=0.05) with poorer overall outcomes in females but not in males.
In contrast, diabetes mellitus significantly correlated with disease severity (p=0.04), neurological deterioration (p=0.05) and haemorrhagic transformation (p=0.03) in males only. Poor disease outcome was significantly associated with diabetes mellitus in both sexes (p<0.01 for both).