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Sex differences in management and outcome after stroke - A Swedish national perspective

Glader, EL; Stegmayr, B; Norrving, Bo LU ; Terent, A; Hulter-Asberg, K; Wester, PO and Asplund, K (2003) In Stroke: a journal of cerebral circulation 34(8). p.1970-1975
Abstract
Background and Purpose-It is disputed whether there are sex differences in management and outcome after stroke; early studies have shown inconsistent results. The objective of this study was to verify and explain differences between men and women in management and outcome after stroke in a national perspective. Methods-In 2001, 20 761 stroke patients were registered in Riks-Stroke, the national quality register for stroke care in Sweden in which all 84 hospitals participate. Data from 9 hospitals that had reported <70% of the estimated stroke events were excluded from analyses, leaving 19 547 patients (9666 women, 9881 men) at 75 hospitals for the present analyses. Results-Women were older than men (77.8 versus 73.2 years). After age... (More)
Background and Purpose-It is disputed whether there are sex differences in management and outcome after stroke; early studies have shown inconsistent results. The objective of this study was to verify and explain differences between men and women in management and outcome after stroke in a national perspective. Methods-In 2001, 20 761 stroke patients were registered in Riks-Stroke, the national quality register for stroke care in Sweden in which all 84 hospitals participate. Data from 9 hospitals that had reported <70% of the estimated stroke events were excluded from analyses, leaving 19 547 patients (9666 women, 9881 men) at 75 hospitals for the present analyses. Results-Women were older than men (77.8 versus 73.2 years). After age adjustment, female patients were more often disabled, living at home with community support, or in institutions before the stroke. They also had a different cardiovascular risk factor profile. Case fatality ratios during the first 3 months were similar in men and women. After 3 months, more women were physically and mentally impaired and dependent on other persons. Female patients with atrial fibrillation received oral anticoagulants less often than men. Even after multiple adjustments for differences between sexes, female sex was independently associated with institutional living 3 months after the stroke (odds ratio, 1.2; 95% confidence interval, 1.0 to 1.4). Conclusions-Women have a worse prestroke condition. Except for case fatality ratios, they also have a worse outcome after stroke after adjustment for other prognostic factors. There are also sex differences in the medical management of stroke that need to be rectified. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
gender, stroke management, delivery of health care, stroke outcome
in
Stroke: a journal of cerebral circulation
volume
34
issue
8
pages
1970 - 1975
publisher
American Heart Association
external identifiers
  • wos:000184482100035
  • pmid:12855818
  • scopus:0041621508
ISSN
1524-4628
DOI
10.1161/01.STR.0000083534.81284.C5
language
English
LU publication?
yes
id
bbbbb3cc-5cce-4325-8d91-0a5451616894 (old id 304800)
date added to LUP
2007-09-03 11:03:13
date last changed
2018-10-14 04:09:07
@article{bbbbb3cc-5cce-4325-8d91-0a5451616894,
  abstract     = {Background and Purpose-It is disputed whether there are sex differences in management and outcome after stroke; early studies have shown inconsistent results. The objective of this study was to verify and explain differences between men and women in management and outcome after stroke in a national perspective. Methods-In 2001, 20 761 stroke patients were registered in Riks-Stroke, the national quality register for stroke care in Sweden in which all 84 hospitals participate. Data from 9 hospitals that had reported &lt;70% of the estimated stroke events were excluded from analyses, leaving 19 547 patients (9666 women, 9881 men) at 75 hospitals for the present analyses. Results-Women were older than men (77.8 versus 73.2 years). After age adjustment, female patients were more often disabled, living at home with community support, or in institutions before the stroke. They also had a different cardiovascular risk factor profile. Case fatality ratios during the first 3 months were similar in men and women. After 3 months, more women were physically and mentally impaired and dependent on other persons. Female patients with atrial fibrillation received oral anticoagulants less often than men. Even after multiple adjustments for differences between sexes, female sex was independently associated with institutional living 3 months after the stroke (odds ratio, 1.2; 95% confidence interval, 1.0 to 1.4). Conclusions-Women have a worse prestroke condition. Except for case fatality ratios, they also have a worse outcome after stroke after adjustment for other prognostic factors. There are also sex differences in the medical management of stroke that need to be rectified.},
  author       = {Glader, EL and Stegmayr, B and Norrving, Bo and Terent, A and Hulter-Asberg, K and Wester, PO and Asplund, K},
  issn         = {1524-4628},
  keyword      = {gender,stroke management,delivery of health care,stroke outcome},
  language     = {eng},
  number       = {8},
  pages        = {1970--1975},
  publisher    = {American Heart Association},
  series       = { Stroke: a journal of cerebral circulation},
  title        = {Sex differences in management and outcome after stroke - A Swedish national perspective},
  url          = {http://dx.doi.org/10.1161/01.STR.0000083534.81284.C5},
  volume       = {34},
  year         = {2003},
}