Sex differences in vascular risk factors, in-hospital management, and outcomes of patients with acute ischemic stroke in China

被引:11
|
作者
Gu, Hong-Qiu [1 ,2 ]
Wang, Chun-Juan [1 ,2 ]
Yang, Xin [1 ,2 ]
Liu, Chelsea [3 ]
Wang, Xia [4 ]
Zhao, Xing-Quan [5 ]
Wang, Yi-Long [5 ]
Liu, Li-Ping [6 ]
Meng, Xia [1 ]
Jiang, Yong [1 ]
Li, Hao [1 ]
Wang, Yong-Jun [1 ,2 ,5 ]
Li, Zi-Xiao [1 ,2 ,5 ,7 ]
机构
[1] Capital Med Univ, Beijing Tiantan Hosp, China Natl Clin Res Ctr Neurol Dis, Beijing, Peoples R China
[2] Capital Med Univ, Beijing Tiantan Hosp, Natl Ctr Healthcare Qual Management Neurol Dis, Beijing, Peoples R China
[3] Harvard TH Chan Sch Publ Hlth, Dept Epidemiol, Boston, MA USA
[4] Univ New South Wales, George Inst Global Hlth, Sydney, NSW, Australia
[5] Capital Med Univ, Beijing Tiantan Hosp, Dept Neurol, Vasc Neurol, Beijing, Peoples R China
[6] Capital Med Univ, Beijing Tiantan Hosp, Dept Neurol, Neurointens Care Unit, Beijing, Peoples R China
[7] Chinese Inst Brain Res, Beijing, Peoples R China
基金
国家重点研发计划; 中国国家自然科学基金;
关键词
guideline-adherence; ischemic stroke; quality of care outcome and process assessment; women and minorities; CARE; PREVALENCE; MORTALITY; QUALITY; WOMEN; EPIDEMIOLOGY; GUIDELINES; RATIONALE; DESIGN; UPDATE;
D O I
10.1111/ene.15124
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Background Previous assessments of sex differences for patients with acute ischemic stroke were limited in a specific region or population, narrow scope, or small sample size. Methods Patients with acute ischemic stroke hospitalized in the China Stroke Center Alliance hospitals were analyzed. Absolute standardized differences (ASDs) were used to assess sex differences in vascular risk factors, guideline-recommended in-hospital management measures and outcomes, including stroke severity (National Institutes of Health Stroke Scale >= 16), death/discharge against medical advice, major adverse cardiovascular events, pneumonia, and disability (modified Rankin Scale >= 3). Results Of 838,229 patients analyzed, 524351 (62.6%) were men and 313,878 (37.4%) were women. Compared with men, women were older (68.6 vs. 64.7 years), had higher prevalence of hypertension (67.7% vs. 62.4%), diabetes (24.7% vs. 19.5%), and atrial fibrillation (7.1% vs. 4.3%), but lower prevalence of smoking (4.5% vs. 56.6%) and drinking (2.6% vs 35.8%) (ASDs >10%). No sex differences were seen in guideline-directed management measures, indicated by risk-adjusted individual measures and the all-or-null summary measure (34.5% vs 34.9%, ASD = 1.0%). Compared to men, women tended to have strokes that were more severe at presentation (6.5% vs. 4.5%, ASD = 8.8%) and more disabilities at discharge (34.9% vs 30.5%, ASD =9.4%). However, all sex-related differences in outcomes were attenuated to null after risk adjustments (ASDs<2%). Conclusions Compared to male patients, female patients had more vascular risk factors and received similar in-hospital care. They had strokes that were more severe at presentation and more disabilities at discharge, both of which may be explained by worse vascular risk profiles.
引用
收藏
页码:188 / 198
页数:11
相关论文
共 50 条
  • [21] Risk factors for in-hospital complications in patients with acute ischemic stroke: Retrospective cohort in a national reference hospital in Peru
    Vences, Miguel A.
    Failoc-Rojas, Virgilio E.
    Urrunaga-Pastor, Diego
    Hurtado-Roca, Yamilee
    HELIYON, 2023, 9 (05)
  • [22] Sex Differences in Management and Outcomes of Acute Ischemic Stroke With Large Vessel Occlusion
    Uchida, Kazutaka
    Yoshimura, Shinichi
    Sakai, Nobuyuki
    Yamagami, Hiroshi
    Morimoto, Takeshi
    STROKE, 2019, 50 (07) : 1915 - 1918
  • [23] Sex Differences in Severity and Risk Factors for Ischemic Stroke in Patients With Hyperlipidemia
    Imeh-Nathaniel, Emmanuel
    Imeh-Nathaniel, Samuel
    Imeh-Nathaniel, Adebobola
    Coker-Ayo, Oreoluwa
    Kulkarni, Nikhil
    Nathaniel, Thomas, I
    NEUROSCIENCE INSIGHTS, 2024, 19
  • [24] Preexisting Heart Disease Spectrum and In-Hospital Outcomes for Patients With Acute Ischemic Stroke
    Gu, Hong-Qiu
    Yang, Kai-Xuan
    Zhao, Xing-Quan
    Wang, Yi-Long
    Liu, Li-Ping
    Li, Zi-Xiao
    Jiang, Yong
    Li, Hao
    Zhang, Wen
    Jin, Ze-Ning
    Han, Jing
    Wang, Yong-Jun
    STROKE-VASCULAR AND INTERVENTIONAL NEUROLOGY, 2024, 4 (06):
  • [25] In-hospital outcomes of thrombolysis for acute ischemic stroke in patients with primary brain tumors
    Murthy, Santosh B.
    Moradiya, Yogesh
    Shah, Shreyansh
    Shastri, Aditi
    Bershad, Eric M.
    Suarez, Jose I.
    JOURNAL OF CLINICAL NEUROSCIENCE, 2015, 22 (03) : 474 - 478
  • [26] In-Hospital Outcomes and Recurrence of Acute Ischemic Stroke in Patients With Solid Organ Malignancy
    Garg, Aayushi
    Chopra, Saurav
    Starr, Matthew
    Rocha, Marcelo
    Dawod, Judy
    Leira, Enrique
    Shaban, Amir
    NEUROLOGY, 2022, 99 (04) : E393 - E401
  • [27] Sex differences in long-term outcomes among acute ischemic stroke patients with diabetes in China
    Wenjuan Zhao
    Zhongping An
    Yan Hong
    Guanen Zhou
    Bin liu
    Jingjing Guo
    Yuanju Yang
    Xianjia Ning
    Jinghua Wang
    Biology of Sex Differences, 6
  • [28] Sex differences in long-term outcomes among acute ischemic stroke patients with diabetes in China
    Zhao, Wenjuan
    An, Zhongping
    Hong, Yan
    Zhou, Guanen
    Liu, Bin
    Guo, Jingjing
    Yang, Yuanju
    Ning, Xianjia
    Wang, Jinghua
    BIOLOGY OF SEX DIFFERENCES, 2015, 6
  • [29] Ten-year trends in sex differences in cardiovascular risk factors, in-hospital management, and outcomes of ischemic stroke in China: Analyses of a nationwide serial cross-sectional survey from 2005 to 2015
    Gu, Hong-Qiu
    Wang, Chun-Juan
    Zhang, Xin-Miao
    Jiang, Yong
    Li, Hao
    Meng, Xia
    Yang, Xin
    Liu, Li-Ping
    Zhao, Xing-Quan
    Wang, Yi-Long
    Wang, Yong-Jun
    Li, Zi-Xiao
    INTERNATIONAL JOURNAL OF STROKE, 2023, 18 (07) : 821 - 828
  • [30] Acute ischemic stroke in octogenarians: Risk factors and in-hospital mortality in a reference hospital from Mexico
    Erwin, Chiquete
    Carlos Omar, Guarena-Serrano
    Lidia Jacqueline, Banuelos-Becerra
    David, Leal-Mora
    Miguel, Flores-Castro
    Ana, Ochoa-Guzman
    Jose Luis, Ruiz-Sandoval
    REVISTA MEXICANA DE NEUROCIENCIA, 2012, 13 (03): : 139 - 145