title: Gender differences in patients with acute ischemic stroke.
abstract: Stroke has a greater effect on women than men owing to the fact that women have more stroke events and are less likely to recover. Age-specific stroke rates are higher in men; however, because of women's longer life expectancy and the much higher incidence of stroke at older ages, women have more stroke events than men overall. The aims of this prospective study in consecutive patients were to assess whether there are gender differences in stroke risk factors, treatment or outcome. Consecutive patients with ischemic stroke were included in this prospective study at four study centers. Disability was assessed using a modified Rankin Scale score (>or=3 indicating disabling stroke) in both genders at 90 days. Outcomes and risk factors in both genders were compared using the chi(2) test. Multiple logistic regression analysis was used to identify any independent predictors of outcome. A total of 1136 patients were included in this study; of these, 494 (46%) were female. Women were statistically older compared with men: 76.02 (+/- 12.93) and 72.68 (+/- 13.27) median years of age, respectively. At admission, females had higher NIH Stroke Scale scores compared with males (9.4 [+/- 6.94] vs 7.6 [+/- 6.28] for men; p = 0.0018). Furthermore, females tended to have more cardioembolic strokes (153 [30%] vs 147 [23%] for men; p = 0.004). Males had lacunar and atherosclerotic strokes more often (146 [29%] vs 249 [39%] for men; p = 0.002, and 68 [13%] vs 123 [19%] for men; p = 0.01, respectively). The mean modified Rankin Scale score at 3 months was also significantly different between genders, at 2.5 (+/- 2.05) for women and 2.1 (+/- 2.02) for men (p = 0.003). However, at multivariate analysis, female gender was not an indicator for negative outcome. It was concluded that female gender was not an independent factor for negative outcome. In addition, both genders demonstrated different stroke pathophysiologies. These findings should be taken into account when diagnostic workup and treatment are being planned.
authors.affiliation: Stroke Unit, Division of Cardiovascular Medicine, University of Perugia, Italy. vcaso@hotmail.com
authors.forename: Valeria
authors.initials: V
authors.lastname: Caso
authors.forename: Maurizio
authors.initials: M
authors.lastname: Paciaroni
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Agnelli
authors.forename: Francesco
authors.initials: F
authors.lastname: Corea
authors.forename: Walter
authors.initials: W
authors.lastname: Ageno
authors.forename: Andrea
authors.initials: A
authors.lastname: Alberti
authors.forename: Alessia
authors.initials: A
authors.lastname: Lanari
authors.forename: Sara
authors.initials: S
authors.lastname: Micheli
authors.forename: Luca
authors.initials: L
authors.lastname: Bertolani
authors.forename: Michele
authors.initials: M
authors.lastname: Venti
authors.forename: Francesco
authors.initials: F
authors.lastname: Palmerini
authors.forename: Antonia M R
authors.initials: AM
authors.lastname: Billeci
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Comi
authors.forename: Paolo
authors.initials: P
authors.lastname: Previdi
authors.forename: Giorgio
authors.initials: G
authors.lastname: Silvestrelli
mesh_terms: D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D002545:Brain Ischemia / Q000453:epidemiology* / Q000209:etiology / Q000628:therapy; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D007558:Italy / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D012737:Sex Factors; D012907:Smoking / Q000009:adverse effects / Q000453:epidemiology; D020521:Stroke / Q000453:epidemiology* / Q000209:etiology / Q000628:therapy; D016896:Treatment Outcome