title: Sex and Age Interactions and Differences in Outcomes After Intracerebral Hemorrhage.
abstract: Compared to ischemic stroke, sex differences in response to intracerebral hemorrhage (ICH) are largely unexplored, and their potential interactions with patient age have not been examined. This study hypothesized that risk for poor outcome is greater in women with increasing age.
  
  
  
  The Get With The Guidelines®-Stroke database was used to assess differences between men and women with ICH. Data from 192,826 ICH patients admitted from January 1, 2009 through March 31, 2014 to 1,728 fully participating sites were analyzed using logistic regression to test interactions between age/sex and outcome.
  
  
  
  In the total study population, 48.9% were women (median age 75; male median age 67). On admission, women over 65 years were less likely to have atrial fibrillation or dyslipidemia, or use antiplatelet therapy or cholesterol reducers, but more likely to suffer worse neurological deficit than men over 65. As age increased, odds of in-hospital mortality increased in both men and women, although the relationship was stronger in men. Odds of combined mortality and discharge to hospice were similar in men and women with increasing age, but odds for discharge to home and independent ambulation at discharge decreased more in women with increasing age.
  
  
  
  After adjusting for covariates, modest sex differences in early outcomes after ICH were linked to age. While statistically significant, detected interactions should be considered in context. Future study may examine whether sex-based interactions represent biologic or treatment differences, unmeasured covariates, or some combination thereof.
authors.affiliation: 1 Departments of Anesthesiology and Neurology, Duke University Medical Center , Durham, North Carolina.
authors.forename: Michael L
authors.initials: ML
authors.lastname: James
authors.affiliation: 2 Duke Clinical Research Institute , Durham, North Carolina.
authors.forename: Margueritte
authors.initials: M
authors.lastname: Cox
authors.affiliation: 2 Duke Clinical Research Institute , Durham, North Carolina.
authors.forename: Ying
authors.initials: Y
authors.lastname: Xian
authors.affiliation: 3 Department of Clinical Neurosciences, Hotchkiss Brain Institute, University of Calgary , Calgary, Canada .
authors.forename: Eric E
authors.initials: EE
authors.lastname: Smith
authors.affiliation: 4 Brigham and Women's Hospital Heart & Vascular Center , Harvard Medical School, Boston, Massachusetts.
authors.forename: Deepak L
authors.initials: DL
authors.lastname: Bhatt
authors.affiliation: 2 Duke Clinical Research Institute , Durham, North Carolina.
authors.forename: Phillip J
authors.initials: PJ
authors.lastname: Schulte
authors.affiliation: 2 Duke Clinical Research Institute , Durham, North Carolina.
authors.forename: Adrian
authors.initials: A
authors.lastname: Hernandez
authors.affiliation: 5 Division of Cardiology, David Geffen School of Medicine at UCLA , Los Angeles, California.
authors.forename: Gregg C
authors.initials: GC
authors.lastname: Fonarow
authors.affiliation: 6 Department of Neurology, Massachusetts General Hospital , Boston, Massachusetts.
authors.forename: Lee H
authors.initials: LH
authors.lastname: Schwamm
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001281:Atrial Fibrillation / Q000453:epidemiology; D002543:Cerebral Hemorrhage / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy*; D005260:Female; D006760:Hospitalization; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009460:Neurologic Examination; D017063:Outcome Assessment, Health Care; D011379:Prognosis; D020127:Recovery of Function; D012727:Sex Characteristics; D012737:Sex Factors; D020521:Stroke / Q000453:epidemiology; D014481:United States / Q000453:epidemiology
keywords: aging; sex; stroke; survival; women