stroke: Tiantan Hospital: Survey of 10,000 stroke patients in China, what is the difference in prognosis between men and women?

Stroke is the leading cause of death and disability worldwide, with an estimated 5.
5 million deaths in 2016
.

Developing countries account for more than two-thirds of the stroke burden

Stroke affects female and male patients differently, but the source and consequences of these differences are unclear
.

Some evidence suggests that female patients have lower in-hospital mortality and more favorable functional outcomes

Previous studies on gender differences have primarily measured stroke outcomes at discharge or in the first few months after stroke onset
.

Still other studies were conducted in a single center, or in small, unrepresentative registries, or did not include potential confounders, leading to controversial gender-related results

With this, Meng Wang et al.
, of Beijing Tiantan Hospital, explored gender differences in stroke outcomes, including stroke recurrence, mortality, and functional outcomes at 3, 6, and 12 months after stroke, a large multi-disciplinary study.
Central Stroke Registry Study, involving hospitals across China
.

Of the 15,166 patients registered between 2015 and 2018, 9,038 patients with acute ischemic stroke (AIS) were included
.

The primary outcomes were stroke recurrence, mortality, and adverse functional outcomes (modified Rankin Scale [mRS] > 2) at 3, 6, and 12 months

Cox regression models were used for stroke recurrence and mortality, and logistic regression models were used for adverse functional outcomes, with the following adjustments
.

(1) Model 1: no adjustment;

(2) Model 2: Adjustment for underlying risk factors, NIHSS on admission, pre-stroke mRS, tissue plasminogen activator (TPA) treatment, TOAST classification, and onset-admission time;

(3) Model 3: In addition to blood pressure and serum covariates, the covariates of Model 2 were adjusted
.

Multiple attribution was used for missing values, and sensitivity analyses were performed to describe sex differences across age groups

They found: One third of the patients (2802/9038) were women
.

Women were significantly older than men (64.
78±10.

The significance of the study lies in its findings: Compared with men, women with AIS in China are less likely to have a favorable outcome within 3 months , especially in people over 65 years of age
.

Experts should aim to tailor secondary prevention strategies for high-risk patients

Compared with men, women with AIS are less likely to have favorable outcomes within 3 months in China

 

Original source:
Wang M, Wang C, Gu HQ, et al.

Sex Differences in Short-term and Long-term Outcomes among Acute Ischemic Stroke Patients in China.
Stroke.
Published online February 8, 2022:STROKEAHA.
121.
037121.
doi:10.
1161 /STROKEAHA.
121.
037121

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