Department of Neurology, Sree ChitraTirunal Institute for Medical Sciences and Technology, Comprehensive Stroke Care Programme, Trivandrum, India.
Sree ChitraTirunal Institute for Medical Sciences and Technology, Achutha Menon Centre for Health Science Studies, Trivandrum, India.
Cerebrovasc Dis Extra. 2021;11(3):106-111. doi: 10.1159/000519540. Epub 2021 Oct 8.
The impact of gender on acute ischemic stroke, in terms of presentation, severity, etiology, and outcome, is increasingly getting recognized. Here, we analyzed the gender-related differences in etiology and outcome of ischemic stroke in South India.
Patients with first ever ischemic stroke within 1 week of onset presenting to the Comprehensive Stroke Care Centre, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, India, were included in our study. Clinical and risk factor profile was documented. The stroke severity was assessed using the National Institutes of Health Stroke Scale (NIHSS) at onset, and stroke subtype classification was done using Trial of Org 10172 in Acute Ischemic Stroke criteria. The 3-month functional outcome was assessed using the modified Rankin Scale (mRS) with excellent outcome defined as an mRS ≤2.
Of the 742 patients, 250 (33.7%) were females. The age, clinical profile, and rate of reperfusion therapies did not differ between the genders. Women suffered more severe strokes (mean NIHSS 9.5 vs. 8.4, p = 0.03). While large artery atherosclerosis was more common in men (21.3% vs. 14.8%, p = 0.03), cardioembolic strokes secondary to rheumatic heart disease were more common in women (27.2% vs. 19.7%, p = 0.02). Men had a better 3-month functional outcome compared to women (68.6% vs. 61.2%, p = 0.04), but was not statistically significant after adjusting for confounders.
Our data, from a single comprehensive stroke unit from South India, suggest that stroke in women are different, yet similar in many ways to men. Guideline-based treatment can result in comparable short-term outcomes, irrespective of admission stroke severity.
越来越多的研究表明，性别对急性缺血性脑卒中的表现、严重程度、病因和结局都有影响。在此，我们分析了印度南部缺血性脑卒中病因和结局的性别差异。
纳入在印度特里凡得琅的 Sree Chitra Tirunal 医学科学与技术研究所综合卒中治疗中心发病 1 周内的首次缺血性脑卒中患者。记录临床和危险因素特征。发病时采用国立卫生研究院卒中量表（NIHSS）评估卒中严重程度，采用急性缺血性卒中组织型纤溶酶原激活剂试验（Trial of Org 10172 in Acute Ischemic Stroke）标准进行卒中亚型分类。采用改良 Rankin 量表（mRS）评估 3 个月的功能结局，良好结局定义为 mRS≤2。
742 例患者中，250 例（33.7%）为女性。两组间的年龄、临床特征和再灌注治疗率没有差异。女性的卒中更严重（平均 NIHSS 9.5 比 8.4，p=0.03）。大动脉粥样硬化在男性中更为常见（21.3%比 14.8%，p=0.03），而风湿性心脏病导致的心源性栓塞性卒中在女性中更为常见（27.2%比 19.7%，p=0.02）。男性 3 个月的功能结局较女性好（68.6%比 61.2%，p=0.04），但在校正混杂因素后无统计学意义。
我们的数据来自印度南部的一个综合性卒中单元，提示女性卒中与男性卒中在很多方面相似，但又存在不同。基于指南的治疗可产生类似的短期结局，而与入院时的卒中严重程度无关。
