Gender differences in mortality and long-term functional outcomes after first-ever ischemic stroke: A prospective cohort study

被引:3
作者
Yun, Sang Moon [1 ]
Shin, Seyoung [1 ]
Chang, Won Hyuk [1 ]
Kim, Deog Young [2 ]
Lee, Jongmin [3 ]
Sohn, Min Kyun [4 ]
Song, Min-Keun [5 ]
Shin, Yong-Il [6 ]
Lee, Yang-Soo [7 ]
Joo, Min Cheol [8 ]
Lee, So Young [9 ]
Han, Junhee [10 ]
Ahn, Jeonghoon [11 ]
Oh, Gyung-Jae [12 ]
Kim, Yun-Hee [1 ,13 ]
机构
[1] Sungkyunkwan Univ, Heart Vasc Stroke Inst, Ctr Prevent & Rehabil, Dept Phys & Rehabil Med,Samsung Med Ctr,Sch Med, 81 Irwon Ro, Seoul 06351, South Korea
[2] Yonsei Univ, Dept & Res Inst Rehabil Med, Coll Med, Seoul, South Korea
[3] Konkuk Univ, Sch Med, Dept Rehabil Med, Seoul, South Korea
[4] Chungnam Natl Univ, Coll Med, Dept Rehabil Med, Daejeon, South Korea
[5] Chonnam Natl Univ, Med Sch, Dept Phys & Rehabil Med, Gwangju, South Korea
[6] Pusan Natl Univ, Yangsan Hosp, Sch Med, Dept Rehabil Med, Yangsan, South Korea
[7] Kyungpook Natl Univ, Kyungpook Natl Univ Hosp, Sch Med, Dept Rehabil Med, Daegu, South Korea
[8] Wonkwang Univ, Sch Med, Dept Rehabil Med, Iksan, South Korea
[9] Jeju Natl Univ, Jeju Natl Univ Hosp, Sch Med, Dept Rehabil Med, Jeju, South Korea
[10] Hallym Univ, Dept Stat, Digital Hlth, SAIHST, Chunchon, South Korea
[11] Ewha Womans Univ, Dept Hlth Convergence, Seoul, South Korea
[12] Wonkwang Univ, Sch Med, Dept Prevent Med, Iksan, South Korea
[13] Sungkyunkwan Univ, Dept Hlth Sci & Technol, SAIHST, Digital Hlth, Seoul, South Korea
基金
新加坡国家研究基金会;
关键词
Stroke; gender; mortality; functional outcome; recovery pattern; SEX-DIFFERENCES; CLINICAL PRESENTATION; CARE;
D O I
10.1177/17474930231159779
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Background: Although many studies about survival rates and functional outcomes after stroke have been published, studies on gender differences have reported conflicting results. Aims: To determine whether there are differences in mortality and functional outcomes during the first 5 years after a first-ever ischemic stroke in Korean males and females. Method: This is an interim analysis of the Korean Stroke Cohort for Functioning and Rehabilitation, a prospective multicenter cohort study. Multifaceted functional assessments were performed repeatedly from 7 days to 60 months after stroke onset to test motor, ambulatory, cognitive, language, and swallowing functions as well as activities of daily living (ADLs) in patients with first-ever stroke. Of 10,636 first-ever-stroke patients admitted to nine representative hospitals in Korea, 8210 were ischemic stroke patients included in the mortality analysis. Among them, 6258 patients provided informed consent and 3508 completed functional assessments for 60 months. Gender-related differences in 5-year mortality and functional recovery were analyzed. Result: Women showed a significantly higher 5-year mortality rate than men after correction for possible covariates (p < 0.05). In terms of functional outcomes, women showed worse ambulatory, cognitive, language, and ADL outcomes than men after adjusting for covariates (all p < 0.05). The 5-year recovery pattern differed significantly between genders only for ADL function (beta-coefficient estimate = 0.34; p = 0.03). Conclusion: Five-year mortality rate, functional outcomes, and recovery patterns after first-ever ischemic stroke differed significantly by gender. These results suggest the need for gender-specific stroke care and long-term management strategies.
引用
收藏
页码:839 / 846
页数:8
相关论文
共 21 条
[1]   Sex, Age, and Socioeconomic Differences in Nonfatal Stroke Incidence and Subsequent Major Adverse Outcomes [J].
Akyea, Ralph K. ;
Vinogradova, Yana ;
Qureshi, Nadeem ;
Patel, Riyaz S. ;
Kontopantelis, Evangelos ;
Ntaios, George ;
Asselbergs, Folkert W. ;
Kai, Joe ;
Weng, Stephen F. .
STROKE, 2021, 52 (02) :396-405
[2]   The Next Frontier-Human Development and the Anthropocene: UNDP Human Development Report 2020 [J].
Baumann, Franz .
ENVIRONMENT, 2021, 63 (03) :34-40
[3]   Female Stroke Sex Differences in Acute Treatment and Early Outcomes of Acute Ischemic Stroke [J].
Bonkhoff, Anna K. ;
Karch, Andre ;
Weber, Ralph ;
Wellmann, Juergen ;
Berger, Klaus .
STROKE, 2021, 52 (02) :406-415
[4]   Sex differences in stroke: Challenges and opportunities [J].
Bushnell, Cheryl D. ;
Chaturvedi, Seemant ;
Gage, Kathy R. ;
Herson, Paco S. ;
Hurn, Patricia D. ;
Jimenez, Monik C. ;
Kittner, Steven J. ;
Madsen, Tracy E. ;
McCullough, Louise D. ;
McDermott, Mollie ;
Reeves, Mathew J. ;
Rundek, Tatjana .
JOURNAL OF CEREBRAL BLOOD FLOW AND METABOLISM, 2018, 38 (12) :2179-2191
[5]   Sex differences in treatment and outcome after stroke Pooled analysis including 19,000 participants [J].
Carcel, Cheryl ;
Wang, Xia ;
Sandset, Else Charlotte ;
Delcourt, Candice ;
Arima, Hisatomi ;
Lindley, Richard ;
Hackett, Maree L. ;
Lavados, Pablo ;
Robinson, Thompson G. ;
Venturelli, Paula Munoz ;
Olavarria, Veronica V. ;
Brunser, Alejandro ;
Berge, Eivind ;
Chalmers, John ;
Woodward, Mark ;
Anderson, Craig S. .
NEUROLOGY, 2019, 93 (24) :E2170-E2180
[6]   Korean Stroke Cohort for functioning and rehabilitation (KOSCO): study rationale and protocol of a multi-centre prospective cohort study [J].
Chang, Won Hyuk ;
Sohn, Min Kyun ;
Lee, Jongmin ;
Kim, Deog Young ;
Lee, Sam-Gyu ;
Shin, Yong-Il ;
Oh, Gyung-Jae ;
Lee, Yang-Soo ;
Joo, Min Cheol ;
Han, Eun Young ;
Kim, Yun-Hee .
BMC NEUROLOGY, 2015, 15
[7]   Sex differences in the clinical presentation, resource use, and 3-month outcome of acute stroke in Europe - Data from a multicenter multinational hospital-based registry [J].
Di Carlo, A ;
Lamassa, M ;
Baldereschi, M ;
Pracucci, G ;
Basile, AM ;
Wolfe, CDA ;
Giroud, M ;
Rudd, A ;
Ghetti, A ;
Inzitari, D .
STROKE, 2003, 34 (05) :1114-1119
[8]   Poststroke Cognitive Outcomes: Sex Differences and Contributing Factors [J].
Dong, Liming ;
Briceno, Emily ;
Morgenstern, Lewis B. ;
Lisabeth, Lynda D. .
JOURNAL OF THE AMERICAN HEART ASSOCIATION, 2020, 9 (14)
[9]   Sex Differences in Stroke Care and Outcome in the Swedish National Quality Register for Stroke Care [J].
Eriksson, Marie ;
Glader, Eva-Lotta ;
Norrving, Bo ;
Terent, Andreas ;
Stegmayr, Birgitta .
STROKE, 2009, 40 (03) :909-914
[10]   World Stroke Organization (WSO): Global Stroke Fact Sheet 2022 [J].
Feigin, Valery L. ;
Brainin, Michael ;
Norrving, Bo ;
Martins, Sheila ;
Sacco, Ralph L. ;
Hacke, Werner ;
Fisher, Marc ;
Pandian, Jeyaraj ;
Lindsay, Patrice .
INTERNATIONAL JOURNAL OF STROKE, 2022, 17 (01) :18-29