Department of Geriatric Medicine and Rehabilitation, Sheba Medical Center, Tel-Hashomer, 52621, Israel.
Arch Gerontol Geriatr. 2012 Sep-Oct;55(2):438-41. doi: 10.1016/j.archger.2011.11.002. Epub 2011 Dec 7.
The purpose of this study was to investigate the effect of gender on the functional outcome after ischemic stroke. In a retrospective chart review we studied 919 survivors of ischemic stroke admitted for rehabilitation at a geriatric rehabilitation ward of a university affiliated hospital. Functional outcome of female and male patients was assessed by Functional Independence Measurement (FIM) at admission and discharge. Data were analyzed by t test, Chi-square test and Linear Regression. A total number of 919 patients were admitted of whom 56% were males. A higher proportion of male patients reported ischemic heart disease (p<0.001), hypercholesterolemia (p=0.035), Parkinson's disease (p=0.044), and previous stroke (p<0.001). Males had also higher Mini-Mental State Examination (MMSE) scores (p<0.001). Total FIM at admission (62.54 ± 25.98 and 66.00 ± 25.49; p=0.043), and total FIM at discharge (80.39 ± 30.35 and 85.59 ± 29.08; p=0.008), motor FIM at admission (40.04 ± 18.89 and 42.51 ± 18.47; p=0.047) and motor FIM at discharge (56.41 ± 23.04 and 60.44 ± 21.84; p=0.007) were higher among male patients. However, a trend for a borderline statistical difference was observed for FIM gains upon discharge between men and women. A multiple linear regression analysis showed that total FIM at discharge was neither associated with male nor female gender (β=-0.009; p=0.69). The findings suggest that the functional outcome of male survivors presenting for rehabilitation after acute ischemic stroke is slightly better. After adjusting for possible covariates, gender did not emerge as an independent predictor for higher FIM at discharge, suggesting that gender should not be held as adversely affecting rehabilitation of such patients.
本研究旨在探讨性别对缺血性脑卒中后功能结局的影响。我们通过回顾性病历分析，研究了在一所大学附属医院老年康复病房接受康复治疗的 919 例缺血性脑卒中幸存者。在入院和出院时，使用功能独立性测量量表（FIM）评估女性和男性患者的功能结局。采用 t 检验、卡方检验和线性回归分析数据。共收治 919 例患者，其中 56%为男性。男性患者更易报告缺血性心脏病（p<0.001）、高胆固醇血症（p=0.035）、帕金森病（p=0.044）和既往卒中（p<0.001）。男性的简易精神状态检查（MMSE）评分也更高（p<0.001）。入院时的总 FIM（62.54 ± 25.98 和 66.00 ± 25.49；p=0.043）和出院时的总 FIM（80.39 ± 30.35 和 85.59 ± 29.08；p=0.008）、入院时的运动 FIM（40.04 ± 18.89 和 42.51 ± 18.47；p=0.047）和出院时的运动 FIM（56.41 ± 23.04 和 60.44 ± 21.84；p=0.007）在男性患者中更高。然而，男性和女性在出院时 FIM 获益方面存在统计学差异的趋势。多元线性回归分析表明，出院时的总 FIM 与男性或女性均无相关性（β=-0.009；p=0.69）。研究结果表明，急性缺血性脑卒中后接受康复治疗的男性幸存者的功能结局略好。在调整了可能的混杂因素后，性别并未成为出院时 FIM 更高的独立预测因素，这表明性别不应被视为此类患者康复的不利因素。
