Gender Differences in Outcomes after Ischemic Stroke: Role of Ischemic Lesion Volume and Intracranial Large-Artery Occlusion

Gender Differences in Outcomes after Ischemic Stroke: Role of Ischemic Lesion Volume and Intracranial Large-Artery Occlusion

Author Silva, Gisele Sampaio Autor UNIFESP Google Scholar
Lima, Fabricio O. Google Scholar
Camargo, Erica C. S. Google Scholar
Smith, Wade S. Google Scholar
Lev, Michael H. Google Scholar
Harris, Gordon J. Google Scholar
Halpern, Elkan F. Google Scholar
Koroshetz, Walter Google Scholar
Furie, Karen L. Google Scholar
Institution Massachusetts Gen Hosp
Harvard Univ
Univ Calif San Francisco
Natl Inst Neurol Disorders & Stroke
Universidade Federal de São Paulo (UNIFESP)
Abstract Background: the reasons for gender disparities in stroke outcome remain unclear, and little is known about the value of acute neuroimaging characteristics in elucidating differential stroke outcomes between the sexes. Methods: We prospectively evaluated consecutive patients with acute ischemic stroke. CT angiography (CTA) was performed in all patients within 24 h of symptom onset. CTA source images were used to evaluate lesion volume. the primary outcome measure was a modified Rankin scale (mRS) score >= 3 at 6 months. Results: We evaluated 676 consecutive patients (322 women). Women were older than men (p < 0.01), more frequently had a prestroke mRS >0 (p < 0.01), and had higher admission National Institutes of Health Stroke scale scores (p = 0.01). More women had intracranial artery occlusions than men (46 vs. 33.1%, p = 0.01), but there was no significant difference between ischemic lesion volumes (p = 0.21). Using multiple regression, female gender remained an independent predictor of poor mRS scores at 6 months (odds ratio 1.57; 95% confidence interval 1.02-2.36) after adjustment for clinical and imaging covariates. Conclusion: Compared with men, women are less likely to achieve independence after acute ischemic stroke. the disparity in stroke outcome is not explained by differences in ischemic lesion volume or the presence of intracranial artery occlusions. Copyright (C) 2010 S. Karger AG, Basel
Keywords Sex differences
Ischemic stroke
CT angiography
Language English
Sponsor Agency for Healthcare Research and Quality
National Institutes of Health
Deane Institute for Integrative Research in Stroke and Atrial Fibrillation
Lakeside Foundation
Grant number Agency for Healthcare Research and Quality: AHRQ R01 HS11392
National Institutes of Health: P50NS051343
Date 2010-01-01
Published in Cerebrovascular Diseases. Basel: Karger, v. 30, n. 5, p. 470-475, 2010.
ISSN 1015-9770 (Sherpa/Romeo, impact factor)
Publisher Karger
Extent 470-475
Access rights Open access Open Access
Type Article
Web of Science ID WOS:000282752200006

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