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Vol. 24, No. 3, 2005
Issue release date: April 2005
Section title: Original Paper
Neuroepidemiology 2005;24:123–128
(DOI:10.1159/000082999)

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

Niewada M. · Kobayashi A. · Sandercock P.A.G. · Kamiński B. · Członkowska A.
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

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Article / Publication Details

First-Page Preview
Abstract of Original Paper

Published online: 4/8/2005

Number of Print Pages: 6
Number of Figures: 0
Number of Tables: 4

ISSN: 0251-5350 (Print)
eISSN: 1423-0208 (Online)

For additional information: http://www.karger.com/NED

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.


Article / Publication Details

First-Page Preview
Abstract of Original Paper

Published online: 4/8/2005

Number of Print Pages: 6
Number of Figures: 0
Number of Tables: 4

ISSN: 0251-5350 (Print)
eISSN: 1423-0208 (Online)

For additional information: http://www.karger.com/NED


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Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher or, in the case of photocopying, direct payment of a specified fee to the Copyright Clearance Center.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in goverment regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

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    External Resources

  25. Cabin HS, Clubb KS, Hall C, et al: Risk for systemic embolization of atrial fibrillation without mitral stenosis. Am J Cardiol 1990;65:1112–1116.
  26. Roquer J, Campello AR, Gomis M: Sex differences in first-ever acute stroke. Stroke 2003;34:1581–1585.
  27. Di Carlo A, Lamassa M, Baldereschi M, et al: 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. Stroke 2003;34:1114–1119.