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远程卒中网络中男性和女性急性缺血性卒中患者的卒中严重程度。

Stroke Severity among Men and Women Acute Ischemic Stroke Patients in the Telestroke Network.

机构信息

University of South Carolina School of Medicine-Greenville, Greenville, South Carolina, USA.

出版信息

Cerebrovasc Dis Extra. 2022;12(2):93-101. doi: 10.1159/000525099. Epub 2022 Jun 8.

Abstract

INTRODUCTION

This study investigates gender differences among stroke patients treated in the telestroke network using specific risk factors that contribute to stroke severity.

METHODS

We examined gender differences in stroke severity among 454 patients hospitalized with acute ischemic stroke (AIS). The logistic regression model was used to predict clinical risk factors associated with stroke severity in men and women AIS patients.

RESULTS

In the adjusted analysis among women patients, increasing age (odds ratio [OR] = 1.05, 95% CI: 1.017-1.085, p = 0.003) and higher heart rate (OR = 1.031, 95% CI: 1.005-1.058, p = 0.021) were associated with worsening neurological functions, while direct admission (OR = 0.191, 95% CI: 0.079-0.465, p < 0.001) was associated with improving neurologic functions. Among men, hypertension (OR = 3.077, 95% CI: 1.060-8.931, p = 0.039) and higher international normalized ratio (INR) (OR = 21.959, 95% CI: 1.489-323.912, p = 0.024) were associated with worsening neurologic functions, while Caucasian (OR = 0.181, 95% CI: 0.062-0.526, p = 0.002) and obesity (OR = 0.449, 95% CI: 0.203-0.99, p = 0.047) were associated with neurologic improvement.

CONCLUSION

Increasing age and heart rate in women, hypertension and greater INR in men contribute to worsening neurologic functions. There is a need to develop strategies to improve the care of both men and women in the telestroke network.

摘要

简介

本研究通过特定的导致中风严重程度的风险因素,探讨了在远程卒中网络中接受治疗的中风患者的性别差异。

方法

我们检查了 454 名因急性缺血性中风(AIS)住院的患者中性别对中风严重程度的影响。使用逻辑回归模型预测与男性和女性 AIS 患者中风严重程度相关的临床风险因素。

结果

在女性患者的调整分析中,年龄增加(比值比[OR] = 1.05,95%置信区间:1.017-1.085,p = 0.003)和心率升高(OR = 1.031,95%置信区间:1.005-1.058,p = 0.021)与神经功能恶化相关,而直接入院(OR = 0.191,95%置信区间:0.079-0.465,p < 0.001)与神经功能改善相关。在男性中,高血压(OR = 3.077,95%置信区间:1.060-8.931,p = 0.039)和更高的国际标准化比值(INR)(OR = 21.959,95%置信区间:1.489-323.912,p = 0.024)与神经功能恶化相关,而白种人(OR = 0.181,95%置信区间:0.062-0.526,p = 0.002)和肥胖(OR = 0.449,95%置信区间:0.203-0.99,p = 0.047)与神经功能改善相关。

结论

女性中年龄和心率的增加,男性中的高血压和更高的 INR 导致神经功能恶化。需要制定策略,以改善远程卒中网络中男性和女性的护理。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4449/9574206/65df29d8a6ca/cee-0012-0093-g01.jpg

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