Influence of Gender on Baseline Features and Clinical Outcomes among 17,370 Patients with Confirmed Ischaemic Stroke in the International Stroke Trial

Vol. 24, No. 3, 2005

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Original Paper

Influence of Gender on Baseline Features and Clinical Outcomes among 17,370 Patients with Confirmed Ischaemic Stroke in the International Stroke Trial
Maciej Niewada^{a, b}, Adam Kobayashi^{a, b}, Peter A.G. Sandercock^c, Bogumi Kamiski^d, Anna Czonkowska^{a, b}, on behalf of the International Stroke Trial Collaborative Group

^aDepartment of Clinical and Experimental Pharmacology, Warsaw Medical University, and
^b2nd Department of Neurology, Institute of Psychiatry and Neurology, Warsaw, Poland;
^cDepartment of Clinical Neurosciences, University of Edinburgh, Edinburgh, UK;
^dDepartment of Division of Decision Analysis and Support, Institute of Econometrics, Warsaw School of Economics, Warsaw, Poland

Address of Corresponding Author

Neuroepidemiology 2005;24:123-128 (DOI: 10.1159/000082999)

Key Words

Gender
Stroke
Mortality
Disability
Recovery

Abstract

Aim: We sought to determine whether there were differences between men and women with acute stroke in their baseline characteristics and outcome in a large cohort of patients randomized in the International Stroke Trial (IST). Methods: Of the 19,435 patients randomized in the IST, 17,370 had an ischemic stroke confirmed by CT scan or autopsy (8,003 female and 9,367 male). In males and females, we compared baseline characteristics (age, frequency of atrial fibrillation, pre-stroke administration of aspirin and systolic blood pressure, conscious level, stroke syndrome) and outcome at 14 days and 6 months (death, complications, dependency, recovery, place of residence). We developed a specific logistic regression model to adjust for case-mix in order to evaluate the separate influence of gender on outcome. Results: Female patients were older, suffered more frequently from atrial fibrillation, had higher systolic blood pressure at randomization and generally had more severe strokes (a higher proportion were unconscious or drowsy or had a total anterior circulation syndrome). Females had higher 14-day and 6-month case fatality and were more likely to be dead or dependent at six months (and consequently more likely to require institutional or residential care). Gender was an independent predictor of death or dependency at 6 months. Conclusions: The adverse effect of female gender on outcome indicates that further research to explore the underlying biological mechanism is justified, and that more intensive acute and long-term treatment may be needed to improve outcome among female patients with stroke.

Author Contacts

Anna Cz lstrok onkowska
2nd Department of Neurology, Institute of Psychiatry and Neurology
9 Sobieskiego Street
PL-02-957 Warsaw (Poland)
Tel. +48 22 8427683, Fax +48 22 8424023, E-Mail czlonkow@ipin.edu.pl

Article Information

Published online: December 30, 2004
Number of Print Pages : 6
Number of Figures : 0, Number of Tables : 4, Number of References : 27

Medline Abstract (ID 15637449)

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