A comparison of risk factors and severity of ischemic stroke in female and male genders in North-West Iran: A cross-sectional study.
Abstract
Background: Gender difference has been reported in stroke risk factors and disease history. The aim of this study was to compare risk factors and the severity of ischemic stroke based upon modified Rankin Scale (mRS) and hospital mortality between two genders.
Methods: In a cross-sectional study, 341 patients (44% males and 56% females with a mean age of 68.94 ± 12.74 years) with ischemic stroke, who were hospitalized in the neurology wards of two referral university hospital of North-West Iran (Imam Reza and Razi Hospitals), from the beginning to the end of 2011 were selected and assessed. Gender difference in terms of demographic findings, vascular risk factors, 7th day mRS, and hospital mortality (during admission) were evaluated.
Results: In 2.6% of cases, mRS was found to be less than 2 (favorable) and in 97.4% of cases; mRS was 2-5 (with disability). No significant difference in ischemic stroke severity based on mRS was observed between two genders. ere was a significant difference in the rate of hypertension (females = 72.3%, males = 59.3%, P = 0.010), diabetes (females = 28.8%, males = 18.7%, P = 0.030), smoking (females = 6.3%, males = 35.3%, P < 0.001). No significant difference was seen in other risk factors between two genders. There was no significant difference in the mortality rate, which constituted 8.9% and 4.7% in females and males respectively (P = 0.140).
Conclusion:The evidence from the present study suggests that despite the existence of some difference between risk-factors in two genders, there was no difference in terms of ischemic stroke severity and mortality rate between two genders.
References
2. Roth EJ, Lovell L, Harvey RL, Heinemann AW, Semik P, Diaz S. Incidence of and risk factors for medical complications during stroke rehabilitation. Stroke 2001; 32(2): 523-9.
3. Taheraghdam AA, Sharifipour E, Pashapour A, Namdar S, Hatami A, Houshmandzad S, et al. Allopurinol as a preventive contrivance after acute ischemic stroke in patients with a high level of serum uric acid: a randomized, controlled trial. Med Princ Pract 2014; 23(2): 134-9.
4. Shaafi Sh, Sharifipour E, Rahmanifar R, Hejazi SS, Andalib S, Nikanfar M, et al. Interleukin-6, a reliable prognostic factor for ischemic stroke. Iran J Neurol 2014; 13(2): 70-6.
5. Mangum SA, Kraenow KR, Narducci WA. Identifying at-risk patients through community pharmacy-based hypertension and stroke prevention screening projects. J Am Pharm Assoc (2003 ) 2003; 43(1): 50-5.
6. Holroyd-Leduc JM, Kapral MK, Austin PC, Tu JV. Sex differences and similarities in the management and outcome of stroke patients. Stroke 2000; 31(8): 1833-7.
7. Glader EL, Stegmayr B, Norrving B, Terent A, Hulter-Asberg K, Wester PO, et al. Sex differences in management and outcome after stroke: a Swedish national perspective. Stroke 2003; 34(8): 1970-5.
8. Borhani-Haghighi A, Safari R, Heydari ST, Soleimani F, Sharifian M, Yektaparast KS, et al. Hospital mortality associated with stroke in southern Iran. Iran J Med Sci 2013; 38(4): 314-20.
9. Kapral MK, Fang J, Hill MD, Silver F, Richards J, Jaigobin C, et al. Sex differences in stroke care and outcomes: results from the Registry of the Canadian Stroke Network. Stroke 2005; 36(4): 809-14.
10. Di Carlo A, Lamassa M, Baldereschi M, Pracucci G, Basile AM, Wolfe CD, et al. Sex differences in the clinical presentation, resource use, and 3-month outcome of acute stroke in Europe: data from a multicenter multinational hospital-based registry. Stroke 2003; 34(5): 1114-9.
11. Megherbi SE, Milan C, Minier D, Couvreur G, Osseby GV, Tilling K, et al. Association between diabetes and stroke subtype on survival and functional outcome 3 months after stroke: data from the European BIOMED Stroke Project. Stroke 2003;34(3): 688-94.
12. Eriksson M, Asplund K, Glader EL, Norrving B, Stegmayr B, Terent A, et al. Self-reported depression and use of antidepressants after stroke: a nationalsurvey. Stroke 2004; 35(4): 936-41.13. Glader EL, Stegmayr B, Asplund K.Poststroke fatigue: a 2-year follow-up study of stroke patients in Sweden. Stroke 2002;33(5): 1327-33.
14. Sturm JW, Donnan GA, Dewey HM, Macdonell RA, Gilligan AK, Srikanth V, et al. Quality of life after stroke: the NorthEast Melbourne Stroke Incidence Study(NEMESIS). Stroke 2004; 35(10): 2340-5.
15. Glader EL, Stegmayr B, Johansson L, Hulter-Asberg K, Wester PO. Differences in long-term outcome between patients treated in stroke units and in general wards: a 2- year follow-up of stroke patients in Sweden. Stroke 2001; 32(9): 2124-30.
16. Labiche LA, Chan W, Saldin KR, Morgenstern LB. Sex and acute stroke presentation. Ann Emerg Med 2002; 40(5): 453-60.
17. Niewada M, Kobayashi A, Sandercock PA, Kaminski B, Czlonkowska A. Influence of gender on baseline features and clinical outcomes among 17,370 patients with confirmed ischaemic stroke in the international stroke trial. Neuroepidemiology 2005; 24(3): 123-8.
18. Oveisgharan S, Sarrafzadegan N, Shirani S, Hosseini S, Hasanzadeh P, Khosravi A. Stroke in Isfahan, Iran: hospital admission and 28-day case fatality rate. Cerebrovasc Dis 2007; 24(6): 495-9.
19. Ghandehari K, Izadi Z. The Khorasan Stroke Registry: results of a five-year hospital-based study. Cerebrovasc Dis 2007; 23(2-3): 132-9.
20. Barrett KM, Brott TG, Brown RD, Jr., Frankel MR, Worrall BB, Silliman SL, et al. Sex differences in stroke severity, symptoms, and deficits after first-ever ischemic stroke. J Stroke Cerebrovasc Dis 2007; 16(1): 34-9.
21. Martinez-Sanchez P, Fuentes B, Fernandez- Dominguez J, Ortega-Casarrubios ML, Aguilar-Amar MJ, Abenza-Abildua MJ, et al. Young women have poorer outcomes than men after stroke. Cerebrovasc Dis 2011; 31(5): 455-63.
22. Salihovic D, Smajlovic D, Sinanovic O, Kojic B. Sex differences in patients with acute ischemic stroke in Tuzla region, Bosnia and Herzegovina. Bosn J Basic Med Sci 2010; 10(2): 116-20.
23. Horner S, Niederkorn K, Schnabl S,Fazekas F. Gender aspects of Ischemic stroke. An analysis of the Austrian Stroke- Unit Registry. Wien Med Wochenschr 2008; 158(15-16): 446-52. [In German].
24. Yesilot NF, Koyuncu BA, Coban O, Tuncay R, Bahar SZ. Gender differences in acute stroke: Istanbul medical school stroke registry. Neurol India 2011; 59(2): 174-9.
25. Roquer J, Campello AR, Gomis M. Sex differences in first-ever acute stroke. Stroke 2003; 34(7): 1581-5.
26. Appelros P, Samuelsson M, Karlsson- Tivenius S, Lokander M, Terent A. A national stroke quality register: 12 years experience from a participating hospital. Eur J Neurol 2007; 14(8): 890-4.
27. Bhattacharjee M, Ahmed S, Rahman KM, Uddin MJ, Dey SK, Israil A, et al. Sex differentiation and risk factor evaluation in stroke patients. Mymensingh Med J 2011; 20(3): 371-6.
28. Ghandehari K, Etemadi M, Nikrad M, Shakeri MT, Mansoori M. Khorasan posterior circulation stroke registry: A hospital-based study. Iran J Med Sci 2008; 33(2): 67-33.
29. Ahangar AA, Ashraf Vaghefi SB, Ramaezani M. Epidemiological evaluation of stroke in Babol, northern Iran (2001- 2003). Eur Neurol 2005; 54(2): 93-7.
30. Delbari A, Salman RR, Tabatabaei SS, Rahgozar M, Lokk J. Stroke epidemiology and one-month fatality among an urban population in Iran. Int J Stroke 2011; 6(3): 195-200.
31. Heuschmann PU, Kolominsky-Rabas PL, Misselwitz B, Hermanek P, Leffmann C, Janzen RW, et al. Predictors of in-hospital mortality and attributable risks of death after ischemic stroke: the German Stroke Registers Study Group. Arch Intern Med 2004; 164(16): 1761-8.
32. Reeves MJ, Bushnell CD, Howard G, Gargano JW, Duncan PW, Lynch G, et al. Sex differences in stroke: epidemiology, clinical presentation, medical care, and outcomes. Lancet Neurol 2008 m; 7(10): 915-26.

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