Julie E Buijs1, Maarten Uyttenboogaart2, Raf Brouns3, Jacques de Keyser3, Pieter Willem Kamphuisen4, Gert-Jan Luijckx2. 1. Department of Neurology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands. Electronic address: j.e.buijs@umcg.nl. 2. Department of Neurology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands. 3. Department of Neurology, Universitair Ziekenhuis Brussel, Center for Neurosciences (C4N), Vrije Universiteit Brussel (VUB), Belgium. 4. Department of Vascular Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
Abstract
BACKGROUND: There are conflicting results regarding the effect of intravenous (IV) recombinant tissue plasminogen activator (rtPA) stroke treatment between men and women. Studies evaluating the impact of sex differences on functional outcome in relation to different age groups are nonexistent. AIM: The objective of the study is to examine the influence of sex differences in relation to age on the prognosis after IV rtPA treatment in acute stroke patients. METHODS: In this cohort study, 887 patients with acute ischemic stroke were treated with rtPA. Functional outcome after 3 months was determined with the modified Rankin Scale (mRS). Good outcome was defined as an mRS score of 2 or lower. Age was stratified in decades (41-50, 51-60, 61-70, 71-80, and >80 years). Multivariable analyses were performed with adjustment for age, sex, stroke severity (National Institutes of Health Stroke Scale [NIHSS]), and stroke subtype (Trial of Org 10172 in Acute Stroke Treatment). RESULTS: Fifty-five percent of the patients were men. The mean age was 67.4 (men) and 72.0 (women) years. Fifty-six percent of the men and 45% of the women had a favorable outcome (P = .001). After adjustment for NIHSS score and stroke subtype, the women had a better outcome in the age group 51-60 years compared with men (odds ratio [OR] .38, 95% confidence interval [CI] .15-.96). In the age group >80 years, men had a better outcome than women (OR 2.69, 95% CI 1.21-5.96). There were no significant differences in the other age groups. CONCLUSION: Men and women have different prognoses after IV rtPA treatment for acute ischemic stroke, which also depends on age. Women in middle age appear to have a better outcome than men, whereas at a more advanced age men appear to have a better outcome than women.
BACKGROUND: There are conflicting results regarding the effect of intravenous (IV) recombinant tissue plasminogen activator (rtPA) stroke treatment between men and women. Studies evaluating the impact of sex differences on functional outcome in relation to different age groups are nonexistent. AIM: The objective of the study is to examine the influence of sex differences in relation to age on the prognosis after IV rtPA treatment in acute strokepatients. METHODS: In this cohort study, 887 patients with acute ischemic stroke were treated with rtPA. Functional outcome after 3 months was determined with the modified Rankin Scale (mRS). Good outcome was defined as an mRS score of 2 or lower. Age was stratified in decades (41-50, 51-60, 61-70, 71-80, and >80 years). Multivariable analyses were performed with adjustment for age, sex, stroke severity (National Institutes of Health Stroke Scale [NIHSS]), and stroke subtype (Trial of Org 10172 in Acute Stroke Treatment). RESULTS: Fifty-five percent of the patients were men. The mean age was 67.4 (men) and 72.0 (women) years. Fifty-six percent of the men and 45% of the women had a favorable outcome (P = .001). After adjustment for NIHSS score and stroke subtype, the women had a better outcome in the age group 51-60 years compared with men (odds ratio [OR] .38, 95% confidence interval [CI] .15-.96). In the age group >80 years, men had a better outcome than women (OR 2.69, 95% CI 1.21-5.96). There were no significant differences in the other age groups. CONCLUSION:Men and women have different prognoses after IV rtPA treatment for acute ischemic stroke, which also depends on age. Women in middle age appear to have a better outcome than men, whereas at a more advanced age men appear to have a better outcome than women.
Authors: Rakesh Khatri; Mohammad Rauf Afzal; Gustavo J Rodriguez; Alberto Maud; Muhammad Shah Miran; Mohtashim Arbaab Qureshi; Salvador Cruz-Flores; Adnan I Qureshi Journal: Neurocrit Care Date: 2018-02 Impact factor: 3.210
Authors: Xia Wang; Yongjun Cao; Daqing Hong; Danni Zheng; Sarah Richtering; Else Charlotte Sandset; Tzen Hugh Leong; Hisatomi Arima; Shariful Islam; Abdul Salam; Craig Anderson; Thompson Robinson; Maree L Hackett Journal: Int J Environ Res Public Health Date: 2016-07-12 Impact factor: 3.390
Authors: Amelia K Boehme; Brendan G Carr; Scott Eric Kasner; Karen C Albright; Michael J Kallan; Mitchell S V Elkind; Charles C Branas; Michael T Mullen Journal: Front Neurol Date: 2017-09-27 Impact factor: 4.003