Abstract P209: Gender Differences in Characteristics, Outcome at Discharge and 3-Month after Stroke in a National Acute Stroke Registry
Introduction: Outcome of stroke has been reported poorer for women compared to men; however patients’ characteristics differ by gender, therefore adjusting for potential confounding effects is crucial for understanding the effect of gender on outcome after stroke.
Hypothesis: We assessed the hypothesis that patients’ characteristics on admission, outcome at discharge and 3-months after stroke differ by gender.
Methods: Data were derived from the triennial two-month national hospital-based Acute Stroke Israeli Registry (Feb-March 2004, March-April 2007, April-May 2010; the NASIS project). Unselected patients admitted to all hospitals (n=28) in Israel were included. Outcome at 3-month was assessed in a sub-sample of patients in the 2007 and 2010 periods. Logistic regression models were used in the study of gender as an independent risk factor for death and poor functional outcome.
Results: In total, 5034 patients [ischemic stroke 4,452 (88.5%), ICH-485 (9.6%), undetermined stroke-97 (1.9%)] were included, of them 2285 (45.4%) women. Women were significantly older [mean (SD) 73.3 (13.1) years] than men [68.7 (12.9)] (p<0.0001). The proportion of hypertension, atrial fibrillation, prior heart disease, peripheral artery disease and prior disability (mRS≥2) was higher in women, and they presented with more severe stroke than men. Rates of in-hospital death and poor functional outcome were higher for women compared with men. Following adjustment for age, NIHSS, risk factors and prior disability, risk estimates (ORs, 95%CI) were 0.7 (0.6-1.0) for in-hospital death, 1.4 (1.0-1.9) for discharge to a nursing home, and 1.0 (0.9-1.2) for disability. Follow-up at 3-month was completed for 1040 patients, 436 (41.9%) women. Rates of 3-month mortality, Barthel Index≤60, dependency by 2-simple questions and living in a nursing home were significantly higher for women compared with men. However, adjusted risk estimates were not higher: OR 1.0 (95%CI 0.5-1.8) for death at 3-months, 1.4 (1.0-2.0) for Barthel Index≤60, 1.2 (0.9-1.7) for dependency and 0.9 (0.6-1.4) for living in a nursing home.
Conclusion: In conclusion, women are at increased risk of death and poor functional outcome after stroke mainly due to differences in age, risk factors, functional status prior to stroke and stroke severity compared with men.
- © 2013 by American Heart Association, Inc.