Department of Neurology and Stroke center, Samsung Medical Center, School of Medicine, Sungkyunkwan University, Seoul, Republic of Korea.
Department of Clinical Research Center, Asan Medical Center, College of Medicine, University of Ulsan, Ulsan, Republic of Korea.
Int J Stroke. 2024 Oct;19(9):1028-1037. doi: 10.1177/17474930241261877. Epub 2024 Jul 24.
Sex differences in stroke outcomes are notable, with women experiencing higher incidence rates, greater disability-adjusted life years, and poorer recovery compared to men, even after adjusting for age and comorbidities. Despite the disproportionate burden in women, studies have reported that women are less likely to receive appropriate stroke treatment than men.
This study investigated temporal trends of sex differences in acute reperfusion therapy and early outcomes in patients with acute ischemic stroke over 10 years in South Korea.
A retrospective analysis of Korean Stroke Registry included patients with acute ischemic stroke from 2012 to 2021. The study outcomes were the temporal trends of acute reperfusion therapy and early outcomes over 10 years in men and women, respectively. In addition, this study analyzed the temporal trends of sex differences in these parameters during the same period. Early outcomes include the proportions of favorable functional outcomes at discharge, discharge patterns, and in-hospital mortality.
A total of 93,692 patients (68.4 years, 40.1% women) with acute ischemic stroke were finally enrolled. Women had a higher age at stroke onset, a higher prevalence of atrial fibrillation, and more severe strokes than men. Women had lower proportion of favorable functional outcomes at discharge and higher proportion of in-hospital mortality compared to men each year. The proportion of patients who received intravenous thrombolysis was lower or similar in women compared to men in most years, and the proportion of patients who received endovascular thrombectomy did not significantly differ between sexes annually. Sex differences in acute reperfusion therapy remained unchanged over 10 years.
Women have received acute reperfusion therapy at similar or lower rates than men and experienced poorer outcomes, despite having more stroke risk factors and often more severe strokes.
卒中结局存在性别差异，女性的发病率、残疾调整生命年（DALY）更高，且恢复情况较男性更差，即使在调整年龄和合并症后也是如此。尽管女性的负担不成比例，但研究报告称，女性接受适当卒中治疗的可能性低于男性。
本研究旨在调查韩国 10 余年来急性缺血性卒中患者接受急性再灌注治疗和早期结局的性别差异的时间趋势。
回顾性分析韩国卒中登记研究，纳入 2012 年至 2021 年期间急性缺血性卒中患者。本研究的结局为男性和女性患者在 10 余年来接受急性再灌注治疗和早期结局的时间趋势。此外，本研究还分析了同期这些参数的性别差异的时间趋势。早期结局包括出院时良好功能结局的比例、出院模式和住院死亡率。
共纳入 93692 例急性缺血性卒中患者（68.4 岁，40.1%为女性）。女性卒中发病年龄更大，心房颤动患病率更高，且卒中更严重。与男性相比，女性出院时良好功能结局的比例更低，住院死亡率更高。每年接受静脉溶栓治疗的女性患者比例均低于或与男性相似，接受血管内取栓术的女性患者比例与男性无显著差异。10 余年来，急性再灌注治疗的性别差异并未改变。
尽管女性具有更多的卒中危险因素且卒中往往更严重，但接受急性再灌注治疗的比例与男性相似或更低，结局更差。
