Sestre Milosrdnice University hospital and Institute of Clinical Medical Research
Abstract
The aim of the study was to identify differences in baseline characteristics and outcomes of men and women with acute ischemic stroke. Ischemic stroke was confirmed by CT scan or autopsy in patients admitted to the 2nd Department of Neurology, Institute of Psychiatry and Neurology in Warsaw, Poland from 1995 to 2007. Male and female patients were compared for risk factors, state of activity prior to stroke, stroke type according to Oxfordshire Community Stroke Project classification, diagnostic test findings, and early 30-day outcome. Data on 1379 women and 1155 men admitted with ischemic stroke were analyzed. The mean age of female and male patients was 74.3 and 68.8 years, respectively. Women were more often disabled prior to stroke, hypertensive, diagnosed with atrial fibrillation or heart failure, and had impaired consciousness at admission, whereas men were more likely to smoke, abuse alcohol and have a history of myocardial infarction or transient ischemic attack. A higher percentage of female stroke patients suffered from total anterior circulation syndrome than males (21.2% and 14.0%, respectively). Internal carotid artery stenosis over 70% was reported in 10.8% of women and 19.1% of men. The 30-day mortality and poor outcome rates were significantly higher in women than men (17.2% vs. 13.1% and 59.9% vs. 46.2%). After adjusting for casemix in multivariate analysis, female sex was independently associated with a higher risk of an early poor outcome. In conclusion, the risk factor distribution, clinical characteristics, diagnostic test findings, and early outcomes were different between female and male ischemic stroke patients. Female sex was associated with poorer prognosis, indicating that more intensive acute and long-term global care may be needed to improve the outcome among female stroke patients.Cilj studije bio je utvrditi razlike u osnovnim značajkama i ishodu između muškaraca i žena s akutnim ishemijskim moždanim udarom. Ishemijski moždani udar potvrđen je kompjutorskom tomografijom ili pri autopsiji u bolesnika primljenih na Drugi neurološki odjel Zavoda za psihijatriju i neurologiju u Varšavi, Poljska, od 1995. do 2007. godine. Bolesnici i bolesnice uspoređeni su u odnosu na rizične čimbenike, stanje aktivnosti prije moždanog udara, vrst moždanog udara prema klasifikaciji Oxfordshire Community Stroke projekta, nalaze dijagnostičkih pretraga i rani 30-dnevni ishod. Analizirali su se podatci za 1379 žena i 1155 muškaraca s ishemijskim moždanim udarom. Srednja dob bolesnica bila je 74,3 godine, a bolesnika 68,8 godina. Žene su češće imale invalidnost prije moždanog udara, kao i hipertenziju, atrijsku fibrilaciju ili srčano zatajenje, te poremećaj svijesti kod prijma, dok je kod muškaraca češće zabilježena navika pušenja, zlouporaba alkohola te povijest infarkta miokarda ili prolaznog ishemijskog napadaja. Bolesnice su u većem postotku patile od sindroma ukupne prednje cirkulacije nego muškarci (21,2% prema 14,0%). Stenoza unutarnje karotidne arterije veća od 70% zabilježena je u 10,8% žena i 19,1% muškaraca. Smrtnost unutar 30 dana i stope lošeg ishoda bile su značajno više u žena negoli u muškaraca (17,2% prema 13,1%, odnosno 59,9% prema 46,2%). Nakon prilagodbe za casemix u multivarijatnoj analizi ženski spol bio je neovisno udružen s većim rizikom za rani loš ishod. U zaključku, raspodjela rizičnih čimbenika, te kliničke značajke, nalazi dijagnostičkih pretraga i rani ishodi razlikovali su se između muških i ženskih bolesnika s ishemijskim moždanim udarom. Ženski spol bio je udružen s lošijom prognozom, ukazujući na potrebu intenzivnije akutne i dugoročne opće skrbi kako bi se poboljšao ishod bolesti među bolesnicama s ishemijskim moždanim udarom
