title: Gender differences in long-term functional outcome after first-ever ischemic stroke.
abstract: OBJECTIVE
  Recent studies have demonstrated gender differences in functional outcome after stroke. However, the underlying reasons for differences have been inconsistent. The present study examined whether gender differences in long-term functional outcomes exist among surviving patients with first-ever ischemic stroke and with individual subtypes of stroke.
  
  
  METHODS
  A total of 997 patients (654 men, 343 women) were followed for 5 years after discharge. Patients were assigned to 4 subtypes of ischemic stroke (atherothrombotic, lacunar, cardioembolic and unclassified infarction). Functional outcomes were expressed as locomotor activity, assessed using a questionnaire delivered by mail 1 and 5 years after stroke. Locomotor function was classified into 5 categories according to the grade of disability.
  
  
  RESULTS
  Women showed significantly worse locomotor function than men at both 1 and 5 years (p < 0.001 and p < 0.01, respectively). Furthermore, significant gender differences in functional outcome were observed in all subtypes of ischemic stroke at 1 and 5 years after stroke. Logistic regression analysis revealed that gender was a significant determinant for functional outcome at 1 and 5 years after stroke (p < 0.01 and p < 0.001, respectively). No significant gender difference was seen in the rate of stroke recurrence. Women also showed a worse survival ratio after stroke than men (p < 0.01).
  
  
  CONCLUSIONS
  The present study demonstrated significantly worse functional outcomes for women than for men at 1 and 5 years after stroke. Gender differences in long-term functional outcomes by subtypes of ischemic stroke were also significant.
authors.affiliation: Faculty of Rehabilitation, School of Allied Health Sciences, Kitasato University, Sagamihara. mifukuda@kitasato-u.ac.jp
authors.forename: Michinari
authors.initials: M
authors.lastname: Fukuda
authors.forename: Tadashi
authors.initials: T
authors.lastname: Kanda
authors.forename: Naoto
authors.initials: N
authors.lastname: Kamide
authors.forename: Tsugio
authors.initials: T
authors.lastname: Akutsu
authors.forename: Fumihiko
authors.initials: F
authors.lastname: Sakai
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006306:Health Surveys; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009043:Motor Activity / Q000502:physiology*; D015999:Multivariate Analysis; D011379:Prognosis; D012008:Recurrence; D012044:Regression Analysis; D012189:Retrospective Studies; D012727:Sex Characteristics; D020521:Stroke / Q000175:diagnosis* / Q000503:physiopathology*