Gender Differences in Outcomes after Ischemic Stroke: Role of Ischemic Lesion Volume and Intracranial Large-Artery Occlusion

Detalhes bibliográficos
Autor(a) principal: Silva, Gisele Sampaio [UNIFESP]
Data de Publicação: 2010
Outros Autores: Lima, Fabricio O., Camargo, Erica C. S., Smith, Wade S., Lev, Michael H., Harris, Gordon J., Halpern, Elkan F., Koroshetz, Walter, Furie, Karen L.
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositório Institucional da UNIFESP
Texto Completo: http://dx.doi.org/10.1159/000317088
http://repositorio.unifesp.br/handle/11600/32038
Resumo: Background: the reasons for gender disparities in stroke outcome remain unclear, and little is known about the value of acute neuroimaging characteristics in elucidating differential stroke outcomes between the sexes. Methods: We prospectively evaluated consecutive patients with acute ischemic stroke. CT angiography (CTA) was performed in all patients within 24 h of symptom onset. CTA source images were used to evaluate lesion volume. the primary outcome measure was a modified Rankin scale (mRS) score >= 3 at 6 months. Results: We evaluated 676 consecutive patients (322 women). Women were older than men (p < 0.01), more frequently had a prestroke mRS >0 (p < 0.01), and had higher admission National Institutes of Health Stroke scale scores (p = 0.01). More women had intracranial artery occlusions than men (46 vs. 33.1%, p = 0.01), but there was no significant difference between ischemic lesion volumes (p = 0.21). Using multiple regression, female gender remained an independent predictor of poor mRS scores at 6 months (odds ratio 1.57; 95% confidence interval 1.02-2.36) after adjustment for clinical and imaging covariates. Conclusion: Compared with men, women are less likely to achieve independence after acute ischemic stroke. the disparity in stroke outcome is not explained by differences in ischemic lesion volume or the presence of intracranial artery occlusions. Copyright (C) 2010 S. Karger AG, Basel
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spelling Gender Differences in Outcomes after Ischemic Stroke: Role of Ischemic Lesion Volume and Intracranial Large-Artery OcclusionSex differencesIschemic strokeCT angiographyBackground: the reasons for gender disparities in stroke outcome remain unclear, and little is known about the value of acute neuroimaging characteristics in elucidating differential stroke outcomes between the sexes. Methods: We prospectively evaluated consecutive patients with acute ischemic stroke. CT angiography (CTA) was performed in all patients within 24 h of symptom onset. CTA source images were used to evaluate lesion volume. the primary outcome measure was a modified Rankin scale (mRS) score >= 3 at 6 months. Results: We evaluated 676 consecutive patients (322 women). Women were older than men (p < 0.01), more frequently had a prestroke mRS >0 (p < 0.01), and had higher admission National Institutes of Health Stroke scale scores (p = 0.01). More women had intracranial artery occlusions than men (46 vs. 33.1%, p = 0.01), but there was no significant difference between ischemic lesion volumes (p = 0.21). Using multiple regression, female gender remained an independent predictor of poor mRS scores at 6 months (odds ratio 1.57; 95% confidence interval 1.02-2.36) after adjustment for clinical and imaging covariates. Conclusion: Compared with men, women are less likely to achieve independence after acute ischemic stroke. the disparity in stroke outcome is not explained by differences in ischemic lesion volume or the presence of intracranial artery occlusions. Copyright (C) 2010 S. Karger AG, BaselMassachusetts Gen Hosp, Dept Neurol, Boston, MA 02114 USAMassachusetts Gen Hosp, Dept Radiol, Boston, MA 02114 USAHarvard Univ, Sch Med, Boston, MA USAUniv Calif San Francisco, Dept Neurol, San Francisco, CA 94143 USANatl Inst Neurol Disorders & Stroke, Bethesda, MD USAUniversidade Federal de São Paulo, Dept Neurol & Neurosurg, São Paulo, BrazilUniversidade Federal de São Paulo, Dept Neurol & Neurosurg, São Paulo, BrazilWeb of ScienceAgency for Healthcare Research and QualityNational Institutes of HealthDeane Institute for Integrative Research in Stroke and Atrial FibrillationLakeside FoundationAgency for Healthcare Research and Quality: AHRQ R01 HS11392National Institutes of Health: P50NS051343KargerMassachusetts Gen HospHarvard UnivUniv Calif San FranciscoNatl Inst Neurol Disorders & StrokeUniversidade Federal de São Paulo (UNIFESP)Silva, Gisele Sampaio [UNIFESP]Lima, Fabricio O.Camargo, Erica C. S.Smith, Wade S.Lev, Michael H.Harris, Gordon J.Halpern, Elkan F.Koroshetz, WalterFurie, Karen L.2016-01-24T13:59:01Z2016-01-24T13:59:01Z2010-01-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersion470-475http://dx.doi.org/10.1159/000317088Cerebrovascular Diseases. Basel: Karger, v. 30, n. 5, p. 470-475, 2010.10.1159/0003170881015-9770http://repositorio.unifesp.br/handle/11600/32038WOS:000282752200006engCerebrovascular Diseasesinfo:eu-repo/semantics/openAccesshttp://www.karger.com/Services/RightsPermissionsreponame:Repositório Institucional da UNIFESPinstname:Universidade Federal de São Paulo (UNIFESP)instacron:UNIFESP2023-05-18T13:34:40Zoai:repositorio.unifesp.br/:11600/32038Repositório InstitucionalPUBhttp://www.repositorio.unifesp.br/oai/requestbiblioteca.csp@unifesp.bropendoar:34652023-05-18T13:34:40Repositório Institucional da UNIFESP - Universidade Federal de São Paulo (UNIFESP)false
dc.title.none.fl_str_mv Gender Differences in Outcomes after Ischemic Stroke: Role of Ischemic Lesion Volume and Intracranial Large-Artery Occlusion
title Gender Differences in Outcomes after Ischemic Stroke: Role of Ischemic Lesion Volume and Intracranial Large-Artery Occlusion
spellingShingle Gender Differences in Outcomes after Ischemic Stroke: Role of Ischemic Lesion Volume and Intracranial Large-Artery Occlusion
Silva, Gisele Sampaio [UNIFESP]
Sex differences
Ischemic stroke
CT angiography
title_short Gender Differences in Outcomes after Ischemic Stroke: Role of Ischemic Lesion Volume and Intracranial Large-Artery Occlusion
title_full Gender Differences in Outcomes after Ischemic Stroke: Role of Ischemic Lesion Volume and Intracranial Large-Artery Occlusion
title_fullStr Gender Differences in Outcomes after Ischemic Stroke: Role of Ischemic Lesion Volume and Intracranial Large-Artery Occlusion
title_full_unstemmed Gender Differences in Outcomes after Ischemic Stroke: Role of Ischemic Lesion Volume and Intracranial Large-Artery Occlusion
title_sort Gender Differences in Outcomes after Ischemic Stroke: Role of Ischemic Lesion Volume and Intracranial Large-Artery Occlusion
author Silva, Gisele Sampaio [UNIFESP]
author_facet Silva, Gisele Sampaio [UNIFESP]
Lima, Fabricio O.
Camargo, Erica C. S.
Smith, Wade S.
Lev, Michael H.
Harris, Gordon J.
Halpern, Elkan F.
Koroshetz, Walter
Furie, Karen L.
author_role author
author2 Lima, Fabricio O.
Camargo, Erica C. S.
Smith, Wade S.
Lev, Michael H.
Harris, Gordon J.
Halpern, Elkan F.
Koroshetz, Walter
Furie, Karen L.
author2_role author
author
author
author
author
author
author
author
dc.contributor.none.fl_str_mv Massachusetts Gen Hosp
Harvard Univ
Univ Calif San Francisco
Natl Inst Neurol Disorders & Stroke
Universidade Federal de São Paulo (UNIFESP)
dc.contributor.author.fl_str_mv Silva, Gisele Sampaio [UNIFESP]
Lima, Fabricio O.
Camargo, Erica C. S.
Smith, Wade S.
Lev, Michael H.
Harris, Gordon J.
Halpern, Elkan F.
Koroshetz, Walter
Furie, Karen L.
dc.subject.por.fl_str_mv Sex differences
Ischemic stroke
CT angiography
topic Sex differences
Ischemic stroke
CT angiography
description Background: the reasons for gender disparities in stroke outcome remain unclear, and little is known about the value of acute neuroimaging characteristics in elucidating differential stroke outcomes between the sexes. Methods: We prospectively evaluated consecutive patients with acute ischemic stroke. CT angiography (CTA) was performed in all patients within 24 h of symptom onset. CTA source images were used to evaluate lesion volume. the primary outcome measure was a modified Rankin scale (mRS) score >= 3 at 6 months. Results: We evaluated 676 consecutive patients (322 women). Women were older than men (p < 0.01), more frequently had a prestroke mRS >0 (p < 0.01), and had higher admission National Institutes of Health Stroke scale scores (p = 0.01). More women had intracranial artery occlusions than men (46 vs. 33.1%, p = 0.01), but there was no significant difference between ischemic lesion volumes (p = 0.21). Using multiple regression, female gender remained an independent predictor of poor mRS scores at 6 months (odds ratio 1.57; 95% confidence interval 1.02-2.36) after adjustment for clinical and imaging covariates. Conclusion: Compared with men, women are less likely to achieve independence after acute ischemic stroke. the disparity in stroke outcome is not explained by differences in ischemic lesion volume or the presence of intracranial artery occlusions. Copyright (C) 2010 S. Karger AG, Basel
publishDate 2010
dc.date.none.fl_str_mv 2010-01-01
2016-01-24T13:59:01Z
2016-01-24T13:59:01Z
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv http://dx.doi.org/10.1159/000317088
Cerebrovascular Diseases. Basel: Karger, v. 30, n. 5, p. 470-475, 2010.
10.1159/000317088
1015-9770
http://repositorio.unifesp.br/handle/11600/32038
WOS:000282752200006
url http://dx.doi.org/10.1159/000317088
http://repositorio.unifesp.br/handle/11600/32038
identifier_str_mv Cerebrovascular Diseases. Basel: Karger, v. 30, n. 5, p. 470-475, 2010.
10.1159/000317088
1015-9770
WOS:000282752200006
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv Cerebrovascular Diseases
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
http://www.karger.com/Services/RightsPermissions
eu_rights_str_mv openAccess
rights_invalid_str_mv http://www.karger.com/Services/RightsPermissions
dc.format.none.fl_str_mv 470-475
dc.publisher.none.fl_str_mv Karger
publisher.none.fl_str_mv Karger
dc.source.none.fl_str_mv reponame:Repositório Institucional da UNIFESP
instname:Universidade Federal de São Paulo (UNIFESP)
instacron:UNIFESP
instname_str Universidade Federal de São Paulo (UNIFESP)
instacron_str UNIFESP
institution UNIFESP
reponame_str Repositório Institucional da UNIFESP
collection Repositório Institucional da UNIFESP
repository.name.fl_str_mv Repositório Institucional da UNIFESP - Universidade Federal de São Paulo (UNIFESP)
repository.mail.fl_str_mv biblioteca.csp@unifesp.br
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