Worse Stroke Outcomes in Women, Review Finds

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Women have worse outcomes after stroke.
Women have worse outcomes after stroke.

HealthDay News — Women have more activity limitations and worse health-related quality of life (HRQoL) after stroke, according to a review published online in Stroke.

Seana Gall, PhD, from the University of Tasmania in Australia, and colleagues reviewed studies from 2007 onward to update the sex differences in patient-reported outcome measures at ≤12 months after stroke. Data were included from 22 studies.

The researchers found that in 8 studies which included ischemic and hemorrhagic stroke, women had worse outcomes than men, with significantly lower odds of good outcome (odds ratio [OR] range, 0.37 to 0.75) or increased odds of poor outcome (OR range, 1.17 to 1.74), in multivariate analyses. 

Women generally had worse outcomes than men in 11 studies of ischemic stroke, with greater odds of poor outcome or lower odds of good outcome; women's significantly worse outcome persisted in seven multivariable adjusted comparisons. Women had more activity limitations than men in the 3 studies of intracerebral hemorrhage. In 2 studies designed to examine sex differences in HRQoL, women had lower mean HRQoL than men. In unadjusted associations reported for eight studies, there was generally more post-stroke depression (PSD) in women, with a higher likelihood of PSD (OR range, 1.27 to 3.15; HR, 3.52). Women did not appear to have worse cognitive impairment.

"Studies exploring potential modifiable contributors to these differences are needed, so effective interventions to reduce sex disparities in outcome can be designed," the authors write.

Reference

Gall S, Phan H, Madsen TE, et al. Focused update of sex differences in patient reported outcome measures after stroke [published online February 8, 2018]. Stroke. doi:10.1161/STROKEAHA.117.018417



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