Sex-Specific Differences in Short-Term and Long-Term Outcomes in Acute Stroke Patients from Qatar
| Autor: | Deborah Morgan, Ashfaq Shuaib, Mahesh Kate, Rajvir Singh, Reny Francis, Namitha Jose, Zain A. Bhutta, Abdel-Naser Elzouki, Yahia Imam, Paula Bourke, Numan Amir, Sujatha Joseph, Maher Saqqur, Saadat Kamran, Blessy Babu, Ahmed Own, Naveed Akhtar |
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| Rok vydání: | 2020 |
| Předmět: |
Adult
Male medicine.medical_specialty medicine.medical_treatment Comorbidity 030204 cardiovascular system & hematology 03 medical and health sciences 0302 clinical medicine Modified Rankin Scale Internal medicine Odds Ratio medicine Humans Social isolation Qatar Stroke Depression (differential diagnoses) Aged Sex Characteristics Rehabilitation business.industry Recovery of Function Odds ratio Middle Aged Prognosis medicine.disease Confidence interval Neurology Etiology Female Neurology (clinical) medicine.symptom business 030217 neurology & neurosurgery |
| Zdroj: | European Neurology. 83:154-161 |
| ISSN: | 1421-9913 0014-3022 |
| Popis: | Background: Sex differences may determine presentation, utility of treatment, rehabilitation, and occurrences of major adverse cardiovascular events (MACEs) in acute stroke (AS). Objective:The purpose of the study was to evaluate the short-term prognosis and long-term outcomes in MACEs in Qatari nationals admitted with AS. Methods: All AS patients admitted between January 2014 and February 2019 were included. We evaluated the preadmission modified Rankin scale (mRS) score, etiology and severity of symptoms, complications, and functional recovery at discharge and 90 days. MACEs were recorded for 5 years. Results: There were 891 admissions for AS (mean age 64.0 ± 14.2 years) (male, n = 519 [mean age ± SD 62.9 ± 14.1 years]; female, n = 372 [mean age ± SD 65.6 ± 14.2 years] p = 0.005). There were no differences in the preadmission mRS and severity of symptoms as measured on National Institute of Stroke Scale. At discharge, the outcome was better (mRS 0–2) in men (57.8 vs. 46.0%), p = 0.0001. This difference persisted at the 90-day follow-up (mRS 0–2, male 69.4% vs. female 53.2%, p = 0.0001). At the 90-day follow-up, more women died (total deaths 70; women 38 [10.2%] versus men 32 [6.2%], p = 0.03). MACEs occurred in 25.6% (133/519) males and 30.9% (115/372) females over the 5-year follow-up period (odds ratio 0.77, 95% confidence interval 0.57–1.0, p = 0.83). Conclusions: Female patients have a poor short-term outcome following an AS when corrected for age and comorbidities. While our study cannot explain the reasons for the discrepancies, higher poststroke depression and social isolation in women may be important contributory factors, and requires further studies are required to confirm these findings. |
| Databáze: | OpenAIRE |
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