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Gender differences in mortality after hospital admission for stroke.
Cerebrovasc Dis. 2009; 28(6):564-71.CD

Abstract

BACKGROUND

Differences between men and women in stroke symptoms, management and disability have been reported to be unfavorable for women. Yet, studies into differences between men and women in survival after a stroke yielded inconsistent results. We investigated whether gender was associated with all-cause mortality after hospital admission for stroke.

METHODS

A nationwide cohort of patients with a first admission for stroke and stroke subtypes was identified through linkage of national registers. Age- and gender-specific mortality risks were quantified for 28-day case-fatality, 1-year and 5-year periods. Cox regression models were used to adjust for potential confounding factors.

RESULTS

We identified 30,675 stroke patients (15,925 women, 14,750 men). In ischemic-stroke patients, 28-day case-fatality, 1-year and 5-year mortality risk (hazard ratio (HR) 0.90; 95% confidence interval (CI) 0.85 to 0.95, HR 0.88; 95% CI 0.84 to 0.92, HR 0.84; 95% CI 0.81 to 0.88, respectively) and in intracerebral-hemorrhage patients, 1-year and 5-year mortality risks (HR 0.92; 95% CI 0.86 to 0.99) were lower for women compared to men after adjustment for age and previous admissions for cardiovascular diseases or diabetes mellitus. In subarachnoid hemorrhage patients, no differences between men and women in crude and adjusted mortality risks were observed. When all stroke types were combined, differences in mortality risk between men and women were seen, and appeared to differ by age (increased risk in young women, lower risk in older women).

CONCLUSIONS

Women have lower 28-day case-fatality and long-term mortality risks after an ischemic stroke and lower 1-year and 5-year mortality risks after an intracerebral hemorrhage compared to men, whereas no differences in mortality risks were found for subarachnoid hemorrhage.

Authors+Show Affiliations

Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands. c.h.vaartjes@umcutrecht.nlNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

19844096

Citation

Vaartjes, I, et al. "Gender Differences in Mortality After Hospital Admission for Stroke." Cerebrovascular Diseases (Basel, Switzerland), vol. 28, no. 6, 2009, pp. 564-71.
Vaartjes I, Reitsma JB, Berger-van Sijl M, et al. Gender differences in mortality after hospital admission for stroke. Cerebrovasc Dis. 2009;28(6):564-71.
Vaartjes, I., Reitsma, J. B., Berger-van Sijl, M., & Bots, M. L. (2009). Gender differences in mortality after hospital admission for stroke. Cerebrovascular Diseases (Basel, Switzerland), 28(6), 564-71. https://doi.org/10.1159/000247600
Vaartjes I, et al. Gender Differences in Mortality After Hospital Admission for Stroke. Cerebrovasc Dis. 2009;28(6):564-71. PubMed PMID: 19844096.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Gender differences in mortality after hospital admission for stroke. AU - Vaartjes,I, AU - Reitsma,J B, AU - Berger-van Sijl,M, AU - Bots,M L, Y1 - 2009/10/16/ PY - 2009/05/25/received PY - 2009/07/15/accepted PY - 2009/10/22/entrez PY - 2009/10/22/pubmed PY - 2010/2/25/medline SP - 564 EP - 71 JF - Cerebrovascular diseases (Basel, Switzerland) JO - Cerebrovasc Dis VL - 28 IS - 6 N2 - BACKGROUND: Differences between men and women in stroke symptoms, management and disability have been reported to be unfavorable for women. Yet, studies into differences between men and women in survival after a stroke yielded inconsistent results. We investigated whether gender was associated with all-cause mortality after hospital admission for stroke. METHODS: A nationwide cohort of patients with a first admission for stroke and stroke subtypes was identified through linkage of national registers. Age- and gender-specific mortality risks were quantified for 28-day case-fatality, 1-year and 5-year periods. Cox regression models were used to adjust for potential confounding factors. RESULTS: We identified 30,675 stroke patients (15,925 women, 14,750 men). In ischemic-stroke patients, 28-day case-fatality, 1-year and 5-year mortality risk (hazard ratio (HR) 0.90; 95% confidence interval (CI) 0.85 to 0.95, HR 0.88; 95% CI 0.84 to 0.92, HR 0.84; 95% CI 0.81 to 0.88, respectively) and in intracerebral-hemorrhage patients, 1-year and 5-year mortality risks (HR 0.92; 95% CI 0.86 to 0.99) were lower for women compared to men after adjustment for age and previous admissions for cardiovascular diseases or diabetes mellitus. In subarachnoid hemorrhage patients, no differences between men and women in crude and adjusted mortality risks were observed. When all stroke types were combined, differences in mortality risk between men and women were seen, and appeared to differ by age (increased risk in young women, lower risk in older women). CONCLUSIONS: Women have lower 28-day case-fatality and long-term mortality risks after an ischemic stroke and lower 1-year and 5-year mortality risks after an intracerebral hemorrhage compared to men, whereas no differences in mortality risks were found for subarachnoid hemorrhage. SN - 1421-9786 UR - https://www.unboundmedicine.com/medline/citation/19844096/Gender_differences_in_mortality_after_hospital_admission_for_stroke_ L2 - https://www.karger.com?DOI=10.1159/000247600 DB - PRIME DP - Unbound Medicine ER -