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Sex differences in presentation, severity, and management of stroke in a population-based study
Citation
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 Statement
Copyright © 2011 American Academy of Neurology
Official URL: http://www.aan.com/
DOI: doi:10.1212/WNL.0b013e3181d5a48f
Abstract
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 womens 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: | Medical and Health Sciences |
| Research Group: | Public Health and Health Services |
| Research Field: | Epidemiology |
| Objective Division: | Health |
| Objective Group: | Clinical Health (Organs, Diseases and Abnormal Conditions) |
| Objective Field: | Cardiovascular System and Diseases |
| UTAS Author: | Gall, SL (Associate Professor Seana Gall) |
| ID Code: | 65856 |
| Year Published: | 2010 |
| Web of Science® Times Cited: | 84 |
| Deposited By: | Menzies Institute for Medical Research |
| Deposited On: | 2010-12-07 |
| Last Modified: | 2011-11-23 |
| Downloads: | 0 |
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