Fan-Yi Kong1, Wen-Dan Tao, Zi-Long Hao, Ming Liu. 1. Stroke Clinical Research Unit, Department of Neurology, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, Chengdu, China.
Abstract
BACKGROUND AND PURPOSE: Women have a worse functional outcome after stroke, but the specific factors associated with a poor outcome in women are rarely reported. This study was designed to investigate the clinical predictors of 1-year disability and death in women after ischemic stroke. METHODS: Patients with ischemic stroke consecutively registered from March 2002 to July 2007 were followed prospectively for 1 year. Multivariate regression models were employed to analyze predictors of disability (defined as modified Rankin scale score, mRS, 3-5) and death. RESULTS: A total of 2,774 ischemic stroke patients were included with 1,119 (40.3%) females (mean age 65 +/- 13.5 years). Among female patients, disability (mRS 3-5) is 1.68-fold higher and case fatality is 1.23-fold higher than in men at the 1-year follow-up. Diabetes is an independent predictor of 1-year disability among women (odds ratio, 1.56; 95% confidence interval, CI, 1.01-2.39). In-hospital acute renal failure (hazard ratio, HR, 7.26; 95% CI, 3.47-5.19), suboptimal antiplatelets (HR, 0.55; 95% CI, 0.37-0.83) and antihypertensive therapy (HR, 0.61; 95% CI, 0.42-0.90) are associated with death at 1 year after stroke among women. CONCLUSIONS: The present study indicates that diabetes, in-hospital acute renal failure, suboptimal antiplatelets and antihypertensive therapy are the possible explanations for the poor 1-year outcome of women hospitalized with ischemic stroke. Copyright 2009 S. Karger AG, Basel.
BACKGROUND AND PURPOSE:Women have a worse functional outcome after stroke, but the specific factors associated with a poor outcome in women are rarely reported. This study was designed to investigate the clinical predictors of 1-year disability and death in women after ischemic stroke. METHODS:Patients with ischemic stroke consecutively registered from March 2002 to July 2007 were followed prospectively for 1 year. Multivariate regression models were employed to analyze predictors of disability (defined as modified Rankin scale score, mRS, 3-5) and death. RESULTS: A total of 2,774 ischemic strokepatients were included with 1,119 (40.3%) females (mean age 65 +/- 13.5 years). Among female patients, disability (mRS 3-5) is 1.68-fold higher and case fatality is 1.23-fold higher than in men at the 1-year follow-up. Diabetes is an independent predictor of 1-year disability among women (odds ratio, 1.56; 95% confidence interval, CI, 1.01-2.39). In-hospital acute renal failure (hazard ratio, HR, 7.26; 95% CI, 3.47-5.19), suboptimal antiplatelets (HR, 0.55; 95% CI, 0.37-0.83) and antihypertensive therapy (HR, 0.61; 95% CI, 0.42-0.90) are associated with death at 1 year after stroke among women. CONCLUSIONS: The present study indicates that diabetes, in-hospital acute renal failure, suboptimal antiplatelets and antihypertensive therapy are the possible explanations for the poor 1-year outcome of women hospitalized with ischemic stroke. Copyright 2009 S. Karger AG, Basel.
Authors: Claudia Diederichs; Kristin Mühlenbruch; Hans-Otto Lincke; Peter U Heuschmann; Martin A Ritter; Klaus Berger Journal: Dtsch Arztebl Int Date: 2011-09-09 Impact factor: 5.594