Menzies Institute for Medical Research University of Tasmania Hobart Australia.
Public Health Management Department Pham Ngoc Thach University of Medicine Ho Chi Minh City Vietnam.
J Am Heart Assoc. 2022 Sep 6;11(17):e026123. doi: 10.1161/JAHA.122.026123. Epub 2022 Sep 3.
Background Women have been reported to have worse health-related quality of life (HRQoL) following stroke than men, but uncertainty exists over the reasons for the sex difference. Methods and Results We included all ischemic strokes registered with the BASIC (Brain Attack Surveillance in Corpus Christi) project (May 2010-December 2016), a population-based stroke study, who completed a 90-day outcome interview. Information on baseline characteristics was obtained from medical records and in-person interviews. HRQoL was measured by the 12-item short-form Stroke Specific Quality of Life Scale. Multivariable Tobit regression was used to estimate the mean difference in overall HRQoL scores (range, 1-5; higher indicating better HRQoL) between sexes and to identify contributing factors to the differences. We included 1061 cases with complete data on HRQoL and covariates (median age, 67 years; 51% women). In unadjusted analyses, women had poorer overall HRQoL than men (mean difference, -0.26 [95% CI, -0.40 to -0.13]). Contributors to this difference included sociodemographic/prestroke factors (eg, age, race and ethnicity, prestroke function), risk factors/comorbidities (eg, history of stroke, Alzheimer disease/dementia), and initial stroke severity. Sociodemographic/prestroke factors explained 62% of the sex difference (mean difference, -0.08 [95% CI, -0.21 to 0.04]). In a fully adjusted model that included adjustment for all confounding factors, the sex difference was eliminated and became nonsignificant (mean difference, -0.03 [95% CI, -0.16 to 0.09]). Conclusions Poorer HRQoL in women compared with men was observed and explained by the combination of sociodemographic and prestroke factors, including physical function before stroke and stroke severity. The findings suggest potential subgroups of women who might benefit from more targeted interventions before and after stroke to improve HRQoL.
据报道，女性在中风后健康相关生活质量（HRQoL）较男性差，但导致性别差异的原因尚不确定。
我们纳入了所有在基于人群的中风研究 BASIC（Corpus Christi 脑部卒中监测）项目（2010 年 5 月至 2016 年 12 月）中登记的缺血性中风患者，这些患者完成了 90 天的结局访谈。基线特征信息来自病历和面对面访谈。HRQoL 通过 12 项简短的中风特异性生活质量量表进行测量。多变量 Tobit 回归用于估计性别间整体 HRQoL 评分（范围，1-5；得分越高，HRQoL 越好）的均值差异，并确定导致差异的因素。我们纳入了 1061 例 HRQoL 和协变量（中位数年龄 67 岁；51%为女性）完整数据的病例。在未调整分析中，女性的整体 HRQoL 较男性差（平均差异，-0.26[95%CI，-0.40 至-0.13]）。导致这种差异的因素包括社会人口学/卒中前因素（如年龄、种族和民族、卒中前功能）、危险因素/合并症（如卒中史、阿尔茨海默病/痴呆）和初始卒中严重程度。社会人口学/卒中前因素解释了 62%的性别差异（平均差异，-0.08[95%CI，-0.21 至 0.04]）。在一个包含所有混杂因素调整的完全调整模型中，性别差异被消除且变得无统计学意义（平均差异，-0.03[95%CI，-0.16 至 0.09]）。
与男性相比，女性的 HRQoL 较差，这是由社会人口学和卒中前因素的组合，包括卒中前的身体功能和卒中严重程度造成的。这些发现表明，可能存在某些女性亚组，她们可能受益于卒中前后更有针对性的干预措施，以改善 HRQoL。
