Sex disparity in acute ischemic stroke outcomes in Korea

Abstract

Background It is unclear whether women diagnosed with acute ischemic stroke (AIS) have worse outcome after adjusting for several confounding factors such as age, initial stroke severity, and risk factors. In this study, we investigated sex disparities in long-term functional outcome after AIS. Methods We recruited patients with AIS prospectively registered in the Clinical Research Collaboration for Stroke in Korea database of Dong-A University Stroke Center between 2015 and 2018. We reviewed the patients’ clinical demographics, living type (alone or cohabitating), laboratory and radiological findings, stroke severity, stroke subtype, and cardiovascular risk profile. We compared the long-term functional outcomes between men and women using the modified Rankin Scale score at 90 days and 1 year after AIS. Results A total of 2,711 patients with AIS were enrolled in this study. Women comprised 38.9% (1,055) of all participants. Compared with men, women were significantly older (72.7±11.6 vs.65.6±12.2, P<0.01), showed more severe neurologic deficits (median National Institutes of Health Stroke Scale, 5 vs. 4, P<0.01), and had a higher rate of living alone (57.1% vs. 42.9%, P<0.01) and a higher prevalence of poor functional outcome at 90 days and 1 year after AIS. However, differences in history of statin use, hospital arrival time, and thrombolysis between the two sexes were not observed. After adjusting for several confounding factors, differences in initial neurologic deficits or long-term functional outcomes between sexes were not observed. Conclusion This study demonstrated the absence of sex disparities in the status of medical attention for thrombolysis.

Keywords

• stroke
• sex
• marital status
• treatment outcome