Sex Differences in Short-Term Outcomes After Acute Ischemic Stroke: The Fukuoka Stroke Registry | Journal Scan

Study Questions:

Do clinical outcomes after stroke differ by sex?

Methods:

Data from 1999 to 2013, collected as part of the Fukuoka Stroke Registry, were used for the present analysis. The Fukuoka Stroke Registry is a multicenter hospital-based registry of Japanese patients with acute stroke treated in seven stroke centers in the Fukuoka Prefecture that is located in southern Japan. Patients who were living independently prior to their stroke and who were admitted within 24 hours of onset of their first-ever stroke were included. Baseline characteristics were assessed on admission. Primary outcomes of interest were neurological improvement, neurological deterioration, and poor functional outcome (modified Rankin Scale score of 3-6 at discharge).

Results:

A total of 6,236 men and women were included, of which 2,398 (38.5%) were women. The mean age of the study subjects was 70.2 ± 12.1 years: women were 5 years older than men. Women were more likely to have dyslipidemia and atrial fibrillation, whereas men were more prone to diabetes mellitus, smoking and drinking habits, ischemic heart diseases, and higher body mass index. Severe stroke (National Institutes of Health Stroke Scale score, ≥8) on admission was more prevalent in women than in men. The frequency of neurological improvement or deterioration during hospitalization was not different between the sexes. After adjusting for possible confounders, including age, stroke subtype and severity, risk factors, and post-stroke treatments, female sex was independently associated with poor functional outcome at discharge (odds ratio, 1.30; 95% confidence interval, 1.08-1.57). There was heterogeneity of the association between sex and poor outcome according to age: women had higher risk of poor outcome than men among patients ages ≥70 years, but no clear sex difference was found in patients ages <70 years.

Conclusions:

The investigators concluded that female sex was associated with the risk of poor functional outcome at discharge after acute ischemic stroke.

Perspective:

These data suggest that women are at risk for poorer function post-stroke. Research to tailor treatments to improve function among such women is warranted.

Clinical Topics: Arrhythmias and Clinical EP, Diabetes and Cardiometabolic Disease, Dyslipidemia, Prevention, Atrial Fibrillation/Supraventricular Arrhythmias, Smoking

Keywords: Atrial Fibrillation, Diabetes Mellitus, Dyslipidemias, Female, Hospitalization, Male, Myocardial Ischemia, National Institutes of Health (U.S.), Registries, Prevalence, Risk Factors, Sex Characteristics, Smoking, Stroke


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