Sex differences in treatment and outcome after stroke: Pooled analysis including 19,000 participants

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dc.contributor.authorCarcel, Cheryl
dc.contributor.authorWang, Xia
dc.contributor.authorSandset, Else
dc.contributor.authorDelcourt, Candice
dc.contributor.authorArima, Hisatomi
dc.contributor.authorLindley, Richard
dc.contributor.authorHackett, Maree
dc.contributor.authorLavados, Pablo
dc.contributor.authorRobinson, Thompson
dc.contributor.authorMuñoz Venturelli, Paula
dc.contributor.authorOlavarría, Verónica
dc.contributor.authorBrunser, Alejandro
dc.contributor.authorBerge, Eivind
dc.contributor.authorChalmers, John
dc.contributor.authorWoodward, Mark
dc.contributor.authorAnderson, Craig
dc.date.accessioned2020-09-11T14:05:46Z
dc.date.available2020-09-11T14:05:46Z
dc.date.issued2019
dc.description.abstractObjective: To explore the sex differences in outcomes and management after stroke using a large sample with high-quality international trial data. Methods: Individual participant data were obtained from 5 acute stroke randomized controlled trials. Data were obtained on demographics, medication use, in-hospital treatment, and functional outcome. Study-specific crude and adjusted models were used to estimate sex differences in outcomes and management, and then pooled using random-effects meta-analysis. Results: There were 19,652 participants, of whom 7,721 (40%) were women. After multivariable adjustments, women with ischemic stroke had higher survival at 3-6 months (odds ratio [OR] 0.82, 95% confidence interval [CI] 0.70-0.97), higher likelihood of disability (OR 1.20, 95% CI 1.06-1.36), and worse quality of life (weighted mean difference -0.07, 95% CI -0.09 to 0.04). For management, women were more likely to be admitted to an acute stroke unit (OR 1.17, 95% CI 1.01-1.34), but less likely to be intubated (OR 0.58, 95% CI 0.36-0.93), treated for fever (OR 0.82, 95% CI 0.70-0.95), or admitted to an intensive care unit (OR 0.83, 95% CI 0.74-0.93). For preadmission medications, women had higher odds of being prescribed antihypertensive agents (OR 1.22, 95% CI 1.13-1.31) and lower odds of being prescribed antiplatelets (OR 0.86, 95% CI 0.79-0.93), glucose-lowering agents (OR 0.86, 95% CI 0.78-0.94), or lipid-lowering agents (OR 0.85, 95% CI 0.77-0.94). Conclusions: This analysis suggests that women who had ischemic stroke had better survival but were also more disabled and had poorer quality of life. Variations in hospital and out-of-hospital management may partly explain the disparities.es
dc.identifier.citationCarcel C, Wang X, Sandset EC, et al. Sex differences in treatment and outcome after stroke: Pooled analysis including 19,000 participants. Neurology. 2019;93(24):e2170-e2180. doi:10.1212/WNL.0000000000008615es
dc.identifier.urihttps://doi.org/10.1212/WNL.0000000000008615es
dc.identifier.urihttp://hdl.handle.net/11447/3421
dc.language.isoenes
dc.publisherAmerican Academy of Neurologyes
dc.subjectSex differenceses
dc.subjectHealthes
dc.subjectStrokees
dc.subjectTreatmentes
dc.subjectWomenes
dc.titleSex differences in treatment and outcome after stroke: Pooled analysis including 19,000 participantses
dc.typeArticlees

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