Labiche Lise A, Chan Wenyaw, Saldin Kamaldeen R, Morgenstern Lewis B
Stroke Program, University of Texas Medical School at Houston, USA.
Ann Emerg Med. 2002 Nov;40(5):453-60. doi: 10.1067/mem.2002.128682.
We determine whether a sex difference exists for acute stroke emergency department presentation.
The TLL Temple Foundation Stroke Project is a prospective observational study of acute stroke management that identified 1,189 validated strokes in nonurban community EDs from February 1998 to March 2000. Structured interview of the patient and the person with the patient at symptom onset identified the symptom or symptoms that prompted the patient to seek medical attention. Interview data were available for 1,124 (94%) patients. A physician blinded to sex classified the reported symptoms into 14 categories.
Nontraditional stroke symptoms were reported by 28% of women and 19% of men (odds ratio 1.62; 95% confidence interval 1.2 to 2.2). Nontraditional stroke symptoms, pain (men 8%, women 12%) and change in level of consciousness (men 12%, women 17%), were more often reported by women. Traditional stroke symptoms, imbalance (men 20%, women 15%) and hemiparesis (men 24%, women 19%), were reported more frequently by men. Trends were also found for women to present with nonneurologic symptoms (men 17%, women 21%) and men to present with gait abnormalities (men 11%, women 8%). There was no sex difference in the mean number of symptoms reported by an individual patient.
This study suggests that a sex difference exists in reporting of acute stroke symptoms. Women with validated strokes present more frequently with nontraditional stroke symptoms than men. Recognition of this difference might yield faster evaluation and management of female patients with acute stroke eligible for acute therapies.
我们确定急性卒中患者在急诊科就诊时是否存在性别差异。
TLL 坦普尔基金会卒中项目是一项关于急性卒中管理的前瞻性观察性研究，该研究在 1998 年 2 月至 2000 年 3 月期间，在非城市社区急诊科识别出 1189 例经证实的卒中患者。对患者及其在症状发作时陪伴的人员进行结构化访谈，以确定促使患者寻求医疗救治的一个或多个症状。1124 例（94%）患者有访谈数据。一名对性别不知情的医生将所报告的症状分为 14 类。
28%的女性和 19%的男性报告了非传统卒中症状（优势比 1.62；95%置信区间 从 1.2 至 2.2）。女性更常报告非传统卒中症状、疼痛（男性 8%，女性 12%）和意识水平改变（男性 12%，女性 17%）。男性更常报告传统卒中症状、失衡（男性 20%，女性 15%）和偏瘫（男性 24%，女性 19%）。还发现女性出现非神经症状（男性 17%，女性 21%）以及男性出现步态异常（男性 11%，女性 8%）的趋势。单个患者报告的症状平均数量不存在性别差异。
本研究表明，急性卒中症状的报告存在性别差异。经证实患有卒中的女性比男性更常出现非传统卒中症状。认识到这种差异可能会使符合急性治疗条件的急性卒中女性患者得到更快的评估和治疗。
