Wiszniewska Malgorzata, Niewada Maciej, Czlonkowska Anna
Department of Neurology, Specialist Hospital, Piła, Poland.
Acta Clin Croat. 2011 Mar;50(1):21-8.
The aim of the study was to identify differences in baseline characteristics and outcomes of men and women with acute ischemic stroke. Ischemic stroke was confirmed by CT scan or autopsy in patients admitted to the 2nd Department of Neurology, Institute of Psychiatry and Neurology in Warsaw, Poland from 1995 to 2007. Male and female patients were compared for risk factors, state of activity prior to stroke, stroke type according to Oxfordshire Community Stroke Project classification, diagnostic test findings, and early 30-day outcome. Data on 1379 women and 1155 men admitted with ischemic stroke were analyzed. The mean age of female and male patients was 74.3 and 68.8 years, respectively. Women were more often disabled prior to stroke, hypertensive, diagnosed with atrial fibrillation or heart failure, and had impaired consciousness at admission, whereas men were more likely to smoke, abuse alcohol and have a history of myocardial infarction or transient ischemic attack. A higher percentage of female stroke patients suffered from total anterior circulation syndrome than males (21.2% and 14.0%, respectively). Internal carotid artery stenosis over 70% was reported in 10.8% ofwomen and 19.1% of men. The 30-day mortality and poor outcome rates were significantly higher in women than men (17.2% vs. 13.1% and 59.9% vs. 46.2%). After adjusting for casemix in multivariate analysis, female sex was independently associated with a higher risk of an early poor outcome. In conclusion, the risk factor distribution, clinical characteristics, diagnostic test findings, and early outcomes were different between female and male ischemic stroke patients. Female sex was associated with poorer prognosis, indicating that more intensive acute and long-term global care may be needed to improve the outcome among female stroke patients.
该研究的目的是确定急性缺血性中风男性和女性患者在基线特征和预后方面的差异。1995年至2007年期间，波兰华沙精神病学和神经病学研究所第二神经内科收治的患者经CT扫描或尸检确诊为缺血性中风。对男性和女性患者的危险因素、中风前的活动状态、根据牛津郡社区中风项目分类的中风类型、诊断检查结果以及30天早期预后进行了比较。分析了1379例女性和1155例男性缺血性中风患者的数据。女性和男性患者的平均年龄分别为74.3岁和68.8岁。女性在中风前更常残疾、患有高血压、被诊断为房颤或心力衰竭，入院时意识障碍，而男性更有可能吸烟、酗酒且有心肌梗死或短暂性脑缺血发作史。女性中风患者中患有完全前循环综合征的比例高于男性（分别为21.2%和14.0%）。10.8%的女性和19.1%的男性报告有超过70%的颈内动脉狭窄。女性的30天死亡率和不良预后率显著高于男性（分别为17.2%对13.1%和59.9%对46.2%）。在多变量分析中对病例组合进行调整后，女性性别独立与早期不良预后风险较高相关。总之，女性和男性缺血性中风患者在危险因素分布、临床特征、诊断检查结果和早期预后方面存在差异。女性性别与较差的预后相关，这表明可能需要更强化的急性和长期全面护理以改善女性中风患者的预后。
