title: Sex-related differences in quality of care and short-term mortality among patients with acute stroke in Denmark: a nationwide follow-up study.
abstract: OBJECTIVE
  Sex may predict level of care and successive outcome among patients with stroke. We examined fulfillment of quality of care criteria according to sex and possible impact of any sex-related differences on short-term mortality in a population-based nationwide follow-up study in Denmark.
  
  
  METHODS
  We identified 29 549 patients admitted with stroke between January 2003 and October 2005 in the Danish National Indicator Project. Data on 30- and 90-day mortality were obtained from The Civil Registration System. We compared proportions of patients receiving adequate care between sexes, as measured by admission to a specialized stroke unit, administration of antiplatelet or anticoagulant therapy, examination with CT/MRI scan, and assessment by a physiotherapist, an occupational therapist, and of nutritional risk. Further, we computed 30- and 90-day mortality rate ratios (MRR), adjusted for patient characteristics, fulfillment of quality of care criteria, and department.
  
  
  RESULTS
  The proportion of patients who received adequate care was either slightly lower or similar among women when compared to men. The relative risks (RR) of receiving specific components of care ranged from 0.84 (95% confidence interval [CI]:0.74 to 0.96) to 1.01 (95% CI:0.96 to 1.06) when comparing sexes. The adjusted mortality rate ratios were lower among women and adjustment for fulfillment of quality of care criteria had only marginal impact.
  
  
  CONCLUSIONS
  There appear not to be any substantial sex-related differences in acute hospital care among patients with stroke in Denmark. The lower female short-term mortality is therefore most likely explained by other factors.
authors.affiliation: Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus N, Denmark. kdp@dce.au.dk
authors.forename: Kaare D
authors.initials: KD
authors.lastname: Palnum
authors.forename: Grethe
authors.initials: G
authors.lastname: Andersen
authors.forename: Annette
authors.initials: A
authors.lastname: Ingeman
authors.forename: Birgitte R
authors.initials: BR
authors.lastname: Krog
authors.forename: Paul
authors.initials: P
authors.lastname: Bartels
authors.forename: Søren P
authors.initials: SP
authors.lastname: Johnsen
mesh_terms: D000208:Acute Disease; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D003718:Denmark / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D011787:Quality of Health Care / Q000706:statistics & numerical data*; D012727:Sex Characteristics; D017678:Sex Distribution; D020521:Stroke / Q000401:mortality* / Q000628:therapy*