title: Gender and age interact to affect early outcome after intracerebral hemorrhage.
abstract: BACKGROUND
  Intracerebral hemorrhage (ICH) is a common and devastating form of cerebrovascular disease. In ICH, gender differences in outcomes remain relatively understudied but have been examined in other neurological emergencies. Further, a potential effect of age and gender on outcomes after ICH has not been explored. This study was designed to test the hypothesis that age and gender interact to modify neurological outcomes after ICH.
  
  
  METHODS
  Adult patients admitted with spontaneous primary supratentorial ICH from July 2007 through April 2010 were assessed via retrospective analysis of an existing stroke database at Duke University. Univariate analysis of collected variables was used to compare gender and outcome. Unfavorable outcome was defined as discharge to hospice or death. Using multivariate regression, the combined effect of age and gender on outcome after ICH was analyzed.
  
  
  RESULTS
  In this study population, women were younger (61.1+14.5 versus 65.8+17.3 years, p=0.03) and more likely to have a history of substance abuse (35% versus 8.9%, p<0.0001) compared to men. Multivariable models demonstrated that advancing age had a greater effect on predicting discharge outcome in women compared to men (p=0.02). For younger patients, female sex was protective; however, at ages greater than 60 years, female sex was a risk factor for discharge to hospice or death.
  
  
  CONCLUSIONS
  While independently associated with discharge to hospice or death after ICH, the interaction effect between gender and age demonstrated significantly stronger correlation with early outcome after ICH in a single center cohort. Prospective study is required to verify these findings.
authors: School of Medicine, Duke University, Durham, North Carolina, United States of America.
authors: Odera
authors: O
authors: Umeano
authors: Barbara
authors: B
authors: Phillips-Bute
authors: Claire E
authors: CE
authors: Hailey
authors: Wei
authors: W
authors: Sun
authors: Marisa C
authors: MC
authors: Gray
authors: Briana
authors: B
authors: Roulhac-Wilson
authors: David L
authors: DL
authors: McDonagh
authors: Peter G
authors: PG
authors: Kranz
authors: Daniel T
authors: DT
authors: Laskowitz
authors: Michael L
authors: ML
authors: James
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D002543:Cerebral Hemorrhage / Q000175:diagnosis* / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009460:Neurologic Examination; D011336:Probability; D011379:Prognosis; D020127:Recovery of Function; D012189:Retrospective Studies; D012737:Sex Factors