Sex-related differences in primary intracerebral hemorrhage.
OBJECTIVE
Little information is available about sex-related differences in intracerebral hemorrhage (ICH). This is a prospective observational study to describe the sex differences in demographics, vascular risk factors, stroke care, and outcomes in primary ICH.


METHODS
BasicMar is a hospital-based registry of all stroke patients admitted to a single public hospital that covers a population of 330,000. From 2005 to 2015, there were 515 consecutive acute primary ICH patients. Outcome data were obtained at 3 months.


RESULTS
More men than women had ICH (52.4% vs 47.6%); the women were older and had worse previous functional status than men, who were more likely to drink alcohol and smoke and to have ischemic heart disease and peripheral arterial disease. There were no sex differences in etiology, severity, or hemorrhage volume. ICH score was greater in women than in men (p = 0.018). Women had more lobar ICH than men (odds ratio adjusted by age was 1.75 [95% confidence interval 1.18-2.58], p = 0.005). The quality of stroke care was similar in both sexes. Mortality at 3 months was 44.1% in women and 41.1% in men (p = 0.656), and 3-month poor outcome among survivors (modified Rankin Scale [mRS] score 3-5) 58.4% in women and 45.3% in men (p = 0.027). After adjustment for previous mRS and ICH score, there were no differences in 3-month mortality or poor outcome at 3 months between sexes.


CONCLUSIONS
Patients with ICH showed sex-related differences in demographic characteristics, ICH location, and vascular risk factors, but not in stroke care, 3-month mortality, or adjusted poor outcome.
From the Servei de Neurologia (J.R., A.R.-C., J.J.-C., E.C.-G., E.G.-S., R.M.V.H., C.S., A.O.), IMIM-Hospital del Mar; Departament de Medicina (J.R., A.R.-C., J.J.-C., A.O.), Universitat Autònoma de Barcelona; and DCEXS (E.C.-G.), Universitat Pompeu Fabra, Barcelona, Spain. jroquer@hospitaldelmar.cat.
Jaume
J
Roquer
From the Servei de Neurologia (J.R., A.R.-C., J.J.-C., E.C.-G., E.G.-S., R.M.V.H., C.S., A.O.), IMIM-Hospital del Mar; Departament de Medicina (J.R., A.R.-C., J.J.-C., A.O.), Universitat Autònoma de Barcelona; and DCEXS (E.C.-G.), Universitat Pompeu Fabra, Barcelona, Spain.
Ana
A
Rodríguez-Campello
From the Servei de Neurologia (J.R., A.R.-C., J.J.-C., E.C.-G., E.G.-S., R.M.V.H., C.S., A.O.), IMIM-Hospital del Mar; Departament de Medicina (J.R., A.R.-C., J.J.-C., A.O.), Universitat Autònoma de Barcelona; and DCEXS (E.C.-G.), Universitat Pompeu Fabra, Barcelona, Spain.
Jordi
J
Jiménez-Conde
From the Servei de Neurologia (J.R., A.R.-C., J.J.-C., E.C.-G., E.G.-S., R.M.V.H., C.S., A.O.), IMIM-Hospital del Mar; Departament de Medicina (J.R., A.R.-C., J.J.-C., A.O.), Universitat Autònoma de Barcelona; and DCEXS (E.C.-G.), Universitat Pompeu Fabra, Barcelona, Spain.
Elisa
E
Cuadrado-Godia
From the Servei de Neurologia (J.R., A.R.-C., J.J.-C., E.C.-G., E.G.-S., R.M.V.H., C.S., A.O.), IMIM-Hospital del Mar; Departament de Medicina (J.R., A.R.-C., J.J.-C., A.O.), Universitat Autònoma de Barcelona; and DCEXS (E.C.-G.), Universitat Pompeu Fabra, Barcelona, Spain.
Eva
E
Giralt-Steinhauer
From the Servei de Neurologia (J.R., A.R.-C., J.J.-C., E.C.-G., E.G.-S., R.M.V.H., C.S., A.O.), IMIM-Hospital del Mar; Departament de Medicina (J.R., A.R.-C., J.J.-C., A.O.), Universitat Autònoma de Barcelona; and DCEXS (E.C.-G.), Universitat Pompeu Fabra, Barcelona, Spain.
Rosa María
RM
Vivanco Hidalgo
From the Servei de Neurologia (J.R., A.R.-C., J.J.-C., E.C.-G., E.G.-S., R.M.V.H., C.S., A.O.), IMIM-Hospital del Mar; Departament de Medicina (J.R., A.R.-C., J.J.-C., A.O.), Universitat Autònoma de Barcelona; and DCEXS (E.C.-G.), Universitat Pompeu Fabra, Barcelona, Spain.
Carol
C
Soriano
From the Servei de Neurologia (J.R., A.R.-C., J.J.-C., E.C.-G., E.G.-S., R.M.V.H., C.S., A.O.), IMIM-Hospital del Mar; Departament de Medicina (J.R., A.R.-C., J.J.-C., A.O.), Universitat Autònoma de Barcelona; and DCEXS (E.C.-G.), Universitat Pompeu Fabra, Barcelona, Spain.
Angel
A
Ois
D000368:Aged; D000369:Aged, 80 and over; D002543:Cerebral Hemorrhage / Q000453:epidemiology* / Q000401:mortality; D019468:Disease Management; D005260:Female; D006801:Humans; D008297:Male; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data; D011446:Prospective Studies; D012042:Registries / Q000706:statistics & numerical data; D012307:Risk Factors; D012720:Severity of Illness Index; D012727:Sex Characteristics; D013030:Spain / Q000453:epidemiology