title: Sex differences in clinical characteristics and outcomes after intracerebral haemorrhage: results from a 12-month prospective stroke registry in Nanjing, China.
abstract: BACKGROUND
  There is uncertainty surrounding the differences in outcomes after intracerebral haemorrhage (ICH) between men and women. This study aimed to investigate the sex differences in clinical characteristics, severity and outcomes of Chinese ICH patients.
  
  
  METHODS
  The Nanjing First Hospital stroke registry was a hospital-based registry of stroke patients with 1-year prospective follow-up. From 2004 to 2008, a total of 651 consecutively recruited patients with acute ICH were enrolled. Primary outcome was death or dependency defined as a modified Rankin Scale score of 3-6 at 12 months. Multivariable logistic regression analyses were performed to determine whether there were sex differences in clinical outcomes after ICH. Clinically important and biologically plausible risk factors of death or dependency were selected from available variables.
  
  
  RESULTS
  A total of 615 ICH patients were enrolled. There was no significant difference in age (63.5 ± 14.0 vs. 62.7 ± 12.7, p = 0.500) between women and men. At baseline, men were more likely to be current smokers (46.1% vs. 3.6%, P < 0.001) or current drinkers (35.4% vs. 3.6%, P < 0.001), but women had higher admission National Institute of Health Stroke Scale (NIHSS) scores than men (10 vs. 8, P = 0.039). Women also had higher rates of death or dependency at 3, 6, and 12 months (61.2% vs. 46.8%, P = 0.001; 56.7% vs. 45.3%, P = 0.009; and 51.8% vs. 44.1%, P = 0.065; respectively). After adjustment for age, existing hypertension and diabetes, prior stroke, previous ischemic heart disease, previous atrial fibrillation, current smoking and alcohol consumption status, pre-stroke dependency, onset-to-door time, admission NIHSS score, admission systolic blood pressure and location of bleeding, the association between the female gender and death or dependency remained statistical significant at 3 months [odds ratio (OR): 1.76; 95% confidence interval (CI): 1.07-2.89], but did not reach statistical significance at 6 months (OR: 1.59; 95% CI: 0.99-2.54) and 12 months (OR: 1.22; 95% CI: 0.77-1.95).
  
  
  CONCLUSIONS
  In a Chinese population, women are more likely to be dead or dependent early after ICH than men. However, this gender difference gradually attenuates over the period of 12 months.
authors.forename: Junshan
authors.initials: J
authors.lastname: Zhou
authors.forename: Yingdong
authors.initials: Y
authors.lastname: Zhang
authors.forename: Hisatomi
authors.initials: H
authors.lastname: Arima
authors.forename: Yanxia
authors.initials: Y
authors.lastname: Zhao
authors.forename: Hongdong
authors.initials: H
authors.lastname: Zhao
authors.forename: Danni
authors.initials: D
authors.lastname: Zheng
authors.forename: Youyong
authors.initials: Y
authors.lastname: Tian
authors.forename: Yukai
authors.initials: Y
authors.lastname: Liu
authors.forename: Qing
authors.initials: Q
authors.lastname: Huang
authors.affiliation: Department of Neurology, Nanjing First Hospital, Nanjing Medical University, 68 Changle Road, Nanjing 210006, Jiangsu, China. yangjie1126@163.com.
authors.forename: Jie
authors.initials: J
authors.lastname: Yang
mesh_terms: D000368:Aged; D002543:Cerebral Hemorrhage / Q000453:epidemiology*; D002681:China / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020127:Recovery of Function; D012042:Registries; D012737:Sex Factors; D020521:Stroke