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Sex differences in presentation, severity, and management of stroke in a population-based study


Gall, SL and Donnan, G and Dewey, HM and Macdonell, R and Sturm, J and Gilligan, A and Srikanth, V and Thrift, AG, Sex differences in presentation, severity, and management of stroke in a population-based study, Neurology, 74, (12) pp. 975-981. ISSN 0028-3878 (2010) [Refereed Article]

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Copyright 2011 American Academy of Neurology

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DOI: doi:10.1212/WNL.0b013e3181d5a48f


Objectives: Women may have poorer outcomes after stroke than men because of differences in their acute management. We examined sex differences in presentation, severity, in-hospital treatment, and early mortality in a cohort of first-ever-in-a-lifetime stroke patients. Methods: Data were collected from May 1, 1996, to April 30, 1999, in the North East Melbourne Stroke Incidence Study. Stroke symptoms, prestroke medical history, in-hospital investigations, admission and discharge medications, initial stroke severity, and 28-day mortality were recorded. Multivariable regression was used to estimate sex differences in treatment, investigations, and 28-day mortality. Results: A total of 1,316 patients were included. Women were older (mean age 76 0.6 vs 72 0.6, p 0.01), had more severe strokes (median NIH Stroke Scale score 6 vs 5, p 0.01), and more likely to experience loss of consciousness (31% vs 23%, p 0.003) and incontinence (22% vs 11%, p 0.01) than men. Women were less often on lipid-lowering therapy on admission. Echocardiography and carotid investigations were less frequently performed in women due to greater age and stroke severity. Women had greater 28-day mortality (32% vs 21%, p 0.001) and stroke severity (44% vs 36%, p0.01) than men, but adjustment for age, comorbidities, and stroke severity (for mortality only) completely attenuated these associations. Conclusion: Sex differences seen in this study were mostly explained by women's older age, greater comorbidity, and stroke severity. The reasons for differences according to age may need further examination.

Item Details

Item Type:Refereed Article
Research Division:Health Sciences
Research Group:Epidemiology
Research Field:Epidemiology not elsewhere classified
Objective Division:Health
Objective Group:Clinical health
Objective Field:Clinical health not elsewhere classified
UTAS Author:Gall, SL (Associate Professor Seana Gall)
ID Code:65856
Year Published:2010
Web of Science® Times Cited:110
Deposited By:Menzies Institute for Medical Research
Deposited On:2010-12-07
Last Modified:2022-07-08

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