Are there gender differences in functional outcome after stroke?

PURPOSE

To study gender differences in functional outcome unexpectedly observed in a follow-up study of stroke patients.

DESIGN

Prospective study of hospitalized stroke patients, with evaluations in the subacute phase and after one year.

SETTING

Geriatric and general medical wards, and geriatric outpatient clinic of a university hospital serving as general hospital for a defined population.

SUBJECTS

All stroke patients admitted during a six-month period (n = 165) were considered for inclusion, of whom 87 could be assessed in the subacute phase and 65 after one year.

MAIN OUTCOME MEASURES

Motor function assessed by the Sødring Motor Evaluation of Stroke Patients; cognitive function by the Assessment of Stroke and other Brain Damage; and activities of daily living (ADL) function by the Barthel Index. Nursing-home residency registered after one year.

RESULTS

Men achieved a significantly better score than women on most of the scales used. The age-adjusted odds for a man to have a higher Barthel score than a woman was 3.1 (95% confidence interval (CI) 1.3-7.0) in the subacute phase and 3.3 (95% CI 1.2-9.0) after one year. Differences of the same magnitude were seen on the subscales of the motor and cognitive tests. The same trend was observed on all items of the Barthel Index. The males had a lower likelihood to be permanent nursing-home residents after one year, the age-adjusted odds ratio for nursing-home residency for females versus males being 6.3 (95% CI 1.2-65.3).

CONCLUSION

Women seem to be functionally more impaired by stroke than men.