国家神经系统疾病临床医学研究中心数据管理与共享系统
Data Management And Sharing System of China National Clinical Research Center for Neurological Diseases
Changes in sex differences and associated factors in stroke outcome among patients with acute ischemic stroke
通讯作者：Yongjun Wang
基本信息
- 负责人：Huihui Liu，Aoming Jin
- 数据来源： CNSR-Ⅲ CNSR-I Golden Bridge
- 论文编号：GOLDEN BRIDGE20220125
- 发表时间：2024-01-09
2024-01-09
已发表文章
主要研究背景及目的
There are many known important sex-related differences in stroke cause, pathophysiology management, and prognosis between men and women. Previous evidence showed that women with AIS were less likely to have favorable outcomes, compared to men with AIS. However, whether sex-related differences in stroke outcome over 10 years has changed and how to be influenced by risk factors have not been studied. We aimed to explore the change of sex-related differences and associated risk factors in stroke outcomes over 10 years
方法
AIS patients were selected from the Third China National Stroke Registry I-III (CNSR I, CNSR II, CNSR III). Changes in sex-related differences in cumulative incidence of stroke recurrence, mortality and change of unfavorable functional outcome among patients with ischemic stroke over 10 years were calculated. Multivariable logistic regression models and Cox regression models were used to examine risk factors associated with changes in sex-related differences in stroke outcomes based on data from CNSR I, CNSR II and III.
结论
This study demonstrated that the sex disparity in poor functional outcome at 12 months was substantially narrowed covering 10 years and completely attenuated in 2015-2018. The findings suggested that women have experienced larger improvements in stroke outcomes than men over the last decade.
主要结果
Among finally included 42,564 patients, 35.4% were female. The age-adjusted event rate of 12-month poor functional outcome and mortality and DALY lost significantly decreased both in males and females after stroke onset (CNSR I, II, and III, all p varies over time <0.001). Female patients showed worse 12-month poor functional outcome in CNSRs I and II (odds ratio [OR] with 95% confidence interval [CI]: 1.22 [1.10-1.36] and 1.13 [1.02-1.25], respectively) compared to males, but the sex difference attenuated in CNSR III (OR with 95% CI: 1.03 [0.91-1.17]), with the significant temporal trend (p varies over time=0.002). The sex difference and the temporal trend of the sex difference in 12-month mortality from 2007 to 2018 were not found (p varies over time= 0.76). The most important factors attenuating the sex difference in poor functional outcome in CNSR I and III were education level, socioeconomic deprivation, baseline stroke severity, and current smoking.