Gender Differences in Outcomes after Ischemic Stroke: Role of Ischemic Lesion Volume and Intracranial Large-Artery Occlusion
Autor(a) principal: | |
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Data de Publicação: | 2010 |
Outros Autores: | , , , , , , , |
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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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 |
_version_ |
1814268340228587520 |