title: Young women have poorer outcomes than men after stroke.
abstract: OBJECTIVE
  Gender differences in stroke outcome have not been fully assessed in young patients.
  
  
  METHODS
  We conducted an observational study of consecutive young ischemic stroke patients (≤ 50 years of age) admitted to a stroke unit (January 1999 to December 2009). Basal data, subtype of ischemic stroke, stroke severity [Canadian Neurological Scale (CNS)], length of hospital stay, inhospital complications, mortality and functional outcome at discharge [modified Rankin Scale (mRS) score] were analyzed. For stroke severity and outcome analyses, 2 age groups were established: 15-30 (very young group) and 31-50 years old (middle-aged young group).
  
  
  RESULTS
  A total of 310 patients were enrolled; 128 females and 182 males. The mean age was similar in women and men (41.07 ± 8.6 vs. 42.12 ± 8.2, NS). Migraine was more frequent in women, whereas arterial hypertension, hyperlipidemia, alcohol abuse, current smoking and atherothrombotic infarction were more frequent in men (p < 0.05). Females presented greater stroke severity than men [median CNS (IQR) = 8 (3.5) vs. 9 (2.5), p = 0.014] except in the very young group [median CNS (IQR) = 9 (1.8) vs. 8 (5), p = 0.022]. Female sex was a predictor of unfavorable outcomes (mRS >2) at discharge in the total sample (OR = 3.33; 95% CI = 1.41-7.84) and in the middle-aged young group (OR = 2.62; 95% CI = 1.05-6.53), adjusted by baseline data, stroke subtype, inhospital complications, length of stay and stroke severity.
  
  
  CONCLUSIONS
  Female gender is associated with worse outcomes in adult ischemic stroke patients up to 50 years old. However, this effect is not observed in younger patients (15-30 years).
authors.affiliation: Stroke Center, Department of Neurology, Neurosciences Area of IdiPAZ Health Research Institute, Hospital Universitario La Paz, Universidad Autónoma de Madrid, Madrid, Spain.
authors.forename: Patricia
authors.initials: P
authors.lastname: Martínez-Sánchez
authors.forename: Blanca
authors.initials: B
authors.lastname: Fuentes
authors.forename: Jessica
authors.initials: J
authors.lastname: Fernández-Domínguez
authors.forename: María de Los Ángeles
authors.initials: Mde L
authors.lastname: Ortega-Casarrubios
authors.forename: María José
authors.initials: MJ
authors.lastname: Aguilar-Amar
authors.forename: María José
authors.initials: MJ
authors.lastname: Abenza-Abildúa
authors.forename: Luis
authors.initials: L
authors.lastname: Idrovo-Freire
authors.forename: Exuperio
authors.initials: E
authors.lastname: Díez-Tejedor
mesh_terms: D000293:Adolescent; D000328:Adult; D002170:Canada / Q000453:epidemiology; D002544:Cerebral Infarction / Q000628:therapy; D002560:Cerebrovascular Circulation / Q000502:physiology; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011247:Pregnancy; D012307:Risk Factors; D012727:Sex Characteristics; D012959:Socioeconomic Factors; D020521:Stroke / Q000150:complications / Q000453:epidemiology* / Q000628:therapy*; D015912:Thrombolytic Therapy; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014930:Women; D055815:Young Adult
chemical_list: D005343:Fibrinolytic Agents; D010959:Tissue Plasminogen Activator