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Neurology. 2010 Mar 23;74(12):975-81. doi: 10.1212/WNL.0b013e3181d5a48f. Epub 2010 Feb 24.

Sex differences in presentation, severity, and management of stroke in a population-based study.

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1
Menzies Research Institute, The University of Tasmania, Private Bag 23, Hobart, Tasmania, Australia, 7000. Seana.Gall@utas.edu.au

Abstract

OBJECTIVES:

Women may have poorer outcomes after stroke than men because of differences in their acute management. We examined sex differences in presentation, severity, in-hospital treatment, and early mortality in a cohort of first-ever-in-a-lifetime stroke patients.

METHODS:

Data were collected from May 1, 1996, to April 30, 1999, in the North East Melbourne Stroke Incidence Study. Stroke symptoms, prestroke medical history, in-hospital investigations, admission and discharge medications, initial stroke severity, and 28-day mortality were recorded. Multivariable regression was used to estimate sex differences in treatment, investigations, and 28-day mortality.

RESULTS:

A total of 1,316 patients were included. Women were older (mean age 76 +/- 0.6 vs 72 +/- 0.6, p < 0.01), had more severe strokes (median NIH Stroke Scale score 6 vs 5, p < 0.01), and more likely to experience loss of consciousness (31% vs 23%, p = 0.003) and incontinence (22% vs 11%, p = 0.01) than men. Women were less often on lipid-lowering therapy on admission. Echocardiography and carotid investigations were less frequently performed in women due to greater age and stroke severity. Women had greater 28-day mortality (32% vs 21%, p < 0.001) and stroke severity (44% vs 36%, p = 0.01) than men, but adjustment for age, comorbidities, and stroke severity (for mortality only) completely attenuated these associations.

CONCLUSION:

Sex differences seen in this study were mostly explained by women's older age, greater comorbidity, and stroke severity. The reasons for differences according to age may need further examination.

PMID:
20181922
DOI:
10.1212/WNL.0b013e3181d5a48f
[Indexed for MEDLINE]
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