Fumi Irie1, Masahiro Kamouchi2, Jun Hata1, Ryu Matsuo1, Yoshinobu Wakisaka1, Junya Kuroda1, Tetsuro Ago1, Takanari Kitazono1. 1. From the Department of Medicine and Clinical Science (F.I., J.H., R.M., Y.W., J.K., T.A., T.K.), Department of Health Care Administration and Management (M.K., R.M.), and Center for Cohort Studies (M.K., J.H., T.K.), Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan; and Department of Nephrology, Hypertension, and Strokology, Kyushu University Hospital, Fukuoka, Japan (Y.W., J.K., T.A., T.K.). 2. From the Department of Medicine and Clinical Science (F.I., J.H., R.M., Y.W., J.K., T.A., T.K.), Department of Health Care Administration and Management (M.K., R.M.), and Center for Cohort Studies (M.K., J.H., T.K.), Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan; and Department of Nephrology, Hypertension, and Strokology, Kyushu University Hospital, Fukuoka, Japan (Y.W., J.K., T.A., T.K.). kamouchi@hcam.med.kyushu-u.ac.jp.
Abstract
BACKGROUND AND PURPOSE: Variable sex differences in clinical outcomes after stroke have been reported worldwide. This study aimed to elucidate whether sex is an independent risk factor of poor functional outcome after acute ischemic stroke. METHODS: Using the database of patients with acute stroke registered in the Fukuoka Stroke Registry in Japan from 1999 to 2013, 6236 previously independent patients with first-ever ischemic stroke who were admitted within 24 hours of onset were included in this study. Baseline characteristics were assessed on admission. Study outcomes included neurological improvement, neurological deterioration, and poor functional outcome (modified Rankin Scale score, 3-6 at discharge). Logistic regression analyses were performed to evaluate the association between sex and clinical outcomes. RESULTS: Overall, 2398 patients (38.5%) were women. Severe stroke (National Institutes of Health Stroke Scale score, ≥8) on admission was more prevalent in women than in men. The frequency of neurological improvement or deterioration during hospitalization was not different between the sexes. After adjusting for possible confounders, including age, stroke subtype and severity, risk factors, and poststroke treatments, it was found that female sex was independently associated with poor functional outcome at discharge (odds ratio, 1.30; 95% confidence interval, 1.08-1.57). There was heterogeneity of the association between sex and poor outcome according to age: women had higher risk of poor outcome than men among patients aged ≥70 years, but no clear sex difference was found in patients aged <70 years. CONCLUSIONS: Female sex was associated with the risk of poor functional outcome at discharge after acute ischemic stroke.
BACKGROUND AND PURPOSE: Variable sex differences in clinical outcomes after stroke have been reported worldwide. This study aimed to elucidate whether sex is an independent risk factor of poor functional outcome after acute ischemic stroke. METHODS: Using the database of patients with acute stroke registered in the Fukuoka Stroke Registry in Japan from 1999 to 2013, 6236 previously independent patients with first-ever ischemic stroke who were admitted within 24 hours of onset were included in this study. Baseline characteristics were assessed on admission. Study outcomes included neurological improvement, neurological deterioration, and poor functional outcome (modified Rankin Scale score, 3-6 at discharge). Logistic regression analyses were performed to evaluate the association between sex and clinical outcomes. RESULTS: Overall, 2398 patients (38.5%) were women. Severe stroke (National Institutes of Health Stroke Scale score, ≥8) on admission was more prevalent in women than in men. The frequency of neurological improvement or deterioration during hospitalization was not different between the sexes. After adjusting for possible confounders, including age, stroke subtype and severity, risk factors, and poststroke treatments, it was found that female sex was independently associated with poor functional outcome at discharge (odds ratio, 1.30; 95% confidence interval, 1.08-1.57). There was heterogeneity of the association between sex and poor outcome according to age: women had higher risk of poor outcome than men among patients aged ≥70 years, but no clear sex difference was found in patients aged <70 years. CONCLUSIONS: Female sex was associated with the risk of poor functional outcome at discharge after acute ischemic stroke.
Authors: Nada El Husseini; Gregg C Fonarow; Eric E Smith; Christine Ju; Lee H Schwamm; Adrian F Hernandez; Phillip J Schulte; Ying Xian; Larry B Goldstein Journal: Stroke Date: 2016-12-29 Impact factor: 7.914
Authors: Abiodun M Adeoye; Bruce Ovbiagele; Joshua O Akinyemi; Okechukwu S Ogah; Rufus Akinyemi; Mulugeta Gebregziabher; Kolawole Wahab; Adekunle G Fakunle; Adeseye Akintunde; Oladimeji Adebayo; Akinyemi Aje; Hemant K Tiwari; Donna Arnett; Francis Agyekum; Lambert T Appiah; Ganiyu Amusa; Taiwo O Olunuga; Akpa Onoja; Fred S Sarfo; Albert Akpalu; Carolyn Jenkins; Daniel Lackland; Lukman Owolabi; Morenikeji Komolafe; Moyinoluwalogo M Faniyan; Oyedunni Arulogun; Reginald Obiako; Mayowa Owolabi Journal: J Am Heart Assoc Date: 2019-05-30 Impact factor: 5.501