Stroke Clinical Research Unit, Department of Neurology, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, Chengdu, China.
Cerebrovasc Dis. 2010 Feb;29(3):255-62. doi: 10.1159/000267852. Epub 2009 Dec 18.
Women have a worse functional outcome after stroke, but the specific factors associated with a poor outcome in women are rarely reported. This study was designed to investigate the clinical predictors of 1-year disability and death in women after ischemic stroke.
Patients with ischemic stroke consecutively registered from March 2002 to July 2007 were followed prospectively for 1 year. Multivariate regression models were employed to analyze predictors of disability (defined as modified Rankin scale score, mRS, 3-5) and death.
A total of 2,774 ischemic stroke patients were included with 1,119 (40.3%) females (mean age 65 +/- 13.5 years). Among female patients, disability (mRS 3-5) is 1.68-fold higher and case fatality is 1.23-fold higher than in men at the 1-year follow-up. Diabetes is an independent predictor of 1-year disability among women (odds ratio, 1.56; 95% confidence interval, CI, 1.01-2.39). In-hospital acute renal failure (hazard ratio, HR, 7.26; 95% CI, 3.47-5.19), suboptimal antiplatelets (HR, 0.55; 95% CI, 0.37-0.83) and antihypertensive therapy (HR, 0.61; 95% CI, 0.42-0.90) are associated with death at 1 year after stroke among women.
The present study indicates that diabetes, in-hospital acute renal failure, suboptimal antiplatelets and antihypertensive therapy are the possible explanations for the poor 1-year outcome of women hospitalized with ischemic stroke.
女性在发生中风后其功能预后更差，但很少有研究报道女性不良预后的具体相关因素。本研究旨在探讨女性缺血性中风后 1 年残疾和死亡的临床预测因素。
连续登记 2002 年 3 月至 2007 年 7 月期间的缺血性中风患者，前瞻性随访 1 年。采用多元回归模型分析残疾（定义为改良 Rankin 量表评分，mRS，3-5 分）和死亡的预测因素。
共纳入 2774 例缺血性中风患者，其中 1119 例（40.3%）为女性（平均年龄 65±13.5 岁）。女性患者在 1 年随访时残疾（mRS 3-5 分）的比例比男性高 1.68 倍，病死率高 1.23 倍。糖尿病是女性 1 年残疾的独立预测因素（比值比，1.56；95%置信区间，CI，1.01-2.39）。住院期间急性肾功能衰竭（HR，7.26；95%CI，3.47-5.19）、抗血小板治疗不理想（HR，0.55；95%CI，0.37-0.83）和降压治疗（HR，0.61；95%CI，0.42-0.90）与女性中风后 1 年死亡相关。
本研究表明，糖尿病、住院期间急性肾功能衰竭、抗血小板治疗不理想和降压治疗可能是女性缺血性中风住院患者预后不良的原因。
