Abstract 4064: Are there Gender-Related Differences in Acute and Prodromal Ischemic Stroke Symptoms?
Introduction: Stroke is a leading cause of disability and death in the US, with higher incidence rates and 1-year mortality for women. In the setting of acute MI, studies suggest that women are more likely than men to present with atypical symptoms; however, minimal data exist on gender differences in stroke symptoms. The purpose of this analysis, part of an ongoing prospective study, was to examine gender differences in the prevalence of acute and prodromal stroke symptoms.
Methods: The sample (n=766; 57% female; mean age 74 years) was drawn from a computerized registry of patients hospitalized with a neurologist-confirmed ischemic stroke at one urban NE teaching hospital. Patient demographics, stroke risk factors (such as current smoking), stroke symptoms, and stroke etiology (according to the TOAST classification system) were abstracted from the computerized medial record by trained abstractors.
Results: No between group differences were observed for age or stroke etiology (p=0.29), but men were more likely than women to have a Hx of MI, CAD, DM, and smoking (p=0.19, 0.003, 0.02, 0.001). Thirty-five percent of the sample (n=270) reported prodomal symptoms. No significant gender difference in the prevalence of self-reported prodromal symptoms was observed; however, men were more likely to report clumsiness (p=.02). While not statistically significant, women were twice as likely to report prodromal malaise (12% vs 6%; p=.10; n=27). Men were more likely to report the acute symptom of difficulty walking (p=.036) despite no gender differences in stroke etiology.
Conclusion: In this research quality dataset, women did not differ from men in the prevalence of self-reported prodromal symptoms but there seems to be some gender differences in the type of both prodromal and acute symptoms reported. We observed a trend for women to report more prodromal malaise, but the cell size was small and merits further study. These findings have implications for practice, suggesting that until more data is available, the focus of stroke prevention education for women should continue to emphasize traditional stroke risk factors.