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J Neurointerv Surg. 2019 Mar;11(3):221-225. doi: 10.1136/neurintsurg-2018-014050. Epub 2018 Aug 10.

Sex differences in 90-day outcomes after mechanical thrombectomy for acute ischemic stroke.

Author information

1
Department of Emergency Medicine, Alpert Medical School of Brown University, Providence, Rhode Island, USA.
2
Alpert Medical School of Brown University, Providence, Rhode Island, USA.
3
Department of Neurology, Alpert Medical School of Brown University, Providence, Rhode Island, USA.
4
Department of Radiology, Alpert Medical School of Brown University, Providence, Rhode Island, USA.

Abstract

BACKGROUND:

It is largely unknown whether functional outcomes after mechanical thrombectomy for large vessel occlusion (LVO) ischemic strokes differ by sex in non-clinical trial populations. We investigated sex differences in 90-day outcomes among ischemic stroke patients receiving mechanical thrombectomy.

METHODS:

This was a prospective cohort of adults treated with mechanical thrombectomy for LVO at a single academic comprehensive stroke center from July 2015 to April 2017. Data on independence (mRS ≤2) at hospital discharge and 90 days were collected prospectively. Multiple logistic regression was used to determine the association between sex and 90-day independence, first adjusting for demographics, pre-stroke mRS, and NIHSS, then by co-morbidities and time to thrombectomy, and finally by vessel recanalization and use of intravenous thrombolysis.

RESULTS:

We included 279 patients, 52% of whom were female. Compared with males, females were older (median years (IQR) 81 (75-88) vs. 71.5 (60-81), P<0.001) and had higher baseline NIHSS (mean SD 18.2±7.5 vs . 16.0±7.1, P=0.02). Similar proportions of males and females had pre-stroke mRS ≤2 (73.3% vs.67.1%, P=0.27). In multivariate analyses, males and females had a similar likelihood of being independent at discharge (aOR 0.71 (95%CI 0.32 to 1.58)), but females were less likely to be independent at 90 days (aOR 0.37 95% CI 0.16 to 0.87).

CONCLUSIONS:

In patients treated with mechanical thrombectomy for LVOs at a large comprehensive stroke center, females were less likely to be independent at 90 days. Future research should investigate contributors to poor outcomes post-discharge in females with LVOs, along with potential interventions to improve outcomes.

KEYWORDS:

stroke; thrombectomy

PMID:
30097482
DOI:
10.1136/neurintsurg-2018-014050
[Indexed for MEDLINE]

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