Sex Differences and Functional Outcome After Intravenous Thrombolysis
© 2017 American Heart Association, Inc..
BACKGROUND AND PURPOSE: Women have a worse outcome after stroke compared with men, although in intravenous thrombolysis (IVT)-treated patients, women seem to benefit more. Besides sex differences, age has also a possible effect on functional outcome. The interaction of sex on the functional outcome in IVT-treated patients in relation to age remains complex. The purpose of this study was to compare outcome after IVT between women and men with regard to age in a large multicenter European cohort reflecting daily clinical practice of acute stroke care.
METHODS: Data were obtained from IVT registries of 12 European tertiary hospitals. The primary outcome was poor functional outcome, defined as a modified Rankin scale score of 3 to 6 at 3 months. We stratified outcome by age in decades. Safety measures were symptomatic intracranial hemorrhage and mortality at 3 months.
RESULTS: In this cohort, 9495 patients were treated with IVT, and 4170 (43.9%) were women with a mean age of 71.9 years. After adjustments for baseline differences, female sex remained associated with poor functional outcome (odds ratio, 1.15; 95% confidence interval, 1.02-1.31). There was no association between sex and functional outcome when data were stratified by age. Symptomatic intracranial hemorrhage rate was similar in both sexes (adjusted odds ratio, 0.93; 95% confidence interval, 0.73-1.19), whereas mortality was lower among women (adjusted odds ratio, 0.83; 95% confidence interval, 0.70-0.99).
CONCLUSIONS: In this large cohort of IVT-treated patients, women more often had poor functional outcome compared with men. This difference was not dependent on age.
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| Medienart: |
E-Artikel |
| Erscheinungsjahr: |
2017 |
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| Erschienen: |
2017 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:48 |
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| Enthalten in: |
Stroke - 48(2017), 3 vom: 31. März, Seite 699-703 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Spaander, Fianne H [VerfasserIn] |
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| Links: |
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| Themen: |
Age distribution |
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| Anmerkungen: |
Date Completed 23.05.2017 Date Revised 08.03.2018 published: Print-Electronic ErratumIn: Stroke. 2017 Mar;48(3):e97. - PMID 28242809 Citation Status MEDLINE |
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| doi: |
10.1161/STROKEAHA.116.014739 |
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| PPN (Katalog-ID): |
NLM268517444 |
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| 245 | 1 | 0 | |a Sex Differences and Functional Outcome After Intravenous Thrombolysis |
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| 500 | |a Date Revised 08.03.2018 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a ErratumIn: Stroke. 2017 Mar;48(3):e97. - PMID 28242809 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2017 American Heart Association, Inc. | ||
| 520 | |a BACKGROUND AND PURPOSE: Women have a worse outcome after stroke compared with men, although in intravenous thrombolysis (IVT)-treated patients, women seem to benefit more. Besides sex differences, age has also a possible effect on functional outcome. The interaction of sex on the functional outcome in IVT-treated patients in relation to age remains complex. The purpose of this study was to compare outcome after IVT between women and men with regard to age in a large multicenter European cohort reflecting daily clinical practice of acute stroke care | ||
| 520 | |a METHODS: Data were obtained from IVT registries of 12 European tertiary hospitals. The primary outcome was poor functional outcome, defined as a modified Rankin scale score of 3 to 6 at 3 months. We stratified outcome by age in decades. Safety measures were symptomatic intracranial hemorrhage and mortality at 3 months | ||
| 520 | |a RESULTS: In this cohort, 9495 patients were treated with IVT, and 4170 (43.9%) were women with a mean age of 71.9 years. After adjustments for baseline differences, female sex remained associated with poor functional outcome (odds ratio, 1.15; 95% confidence interval, 1.02-1.31). There was no association between sex and functional outcome when data were stratified by age. Symptomatic intracranial hemorrhage rate was similar in both sexes (adjusted odds ratio, 0.93; 95% confidence interval, 0.73-1.19), whereas mortality was lower among women (adjusted odds ratio, 0.83; 95% confidence interval, 0.70-0.99) | ||
| 520 | |a CONCLUSIONS: In this large cohort of IVT-treated patients, women more often had poor functional outcome compared with men. This difference was not dependent on age | ||
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| 700 | 1 | |a Gensicke, Henrik |e verfasserin |4 aut | |
| 700 | 1 | |a Polymeris, Alexandros |e verfasserin |4 aut | |
| 700 | 1 | |a Traenka, Christopher |e verfasserin |4 aut | |
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| 700 | 1 | |a Kägi, Georg |e verfasserin |4 aut | |
| 700 | 1 | |a Pezzini, Alessandro |e verfasserin |4 aut | |
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| 700 | 1 | |a Engelter, Stefan T |e verfasserin |4 aut | |
| 700 | 1 | |a Nederkoorn, Paul J |e verfasserin |4 aut | |
| 700 | 0 | |a Thrombolysis in Ischemic Stroke Patients Collaborators (TrISP) |e verfasserin |4 aut | |
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