Sex Differences and Functional Outcome After Intravenous Thrombolysis.

Details

Serval ID
serval:BIB_BA13D0E88F1E
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Sex Differences and Functional Outcome After Intravenous Thrombolysis.
Journal
Stroke
Author(s)
Spaander F.H., Zinkstok S.M., Baharoglu I.M., Gensicke H., Polymeris A., Traenka C., Hametner C., Ringleb P., Curtze S., Martinez-Majander N., Aarnio K., Nolte C.H., Scheitz J.F., Leys D., Hochart A., Padjen V., Kägi G., Pezzini A., Michel P., Bill O., Zini A., Engelter S.T., Nederkoorn P.J.
Working group(s)
Thrombolysis in Ischemic Stroke Patients Collaborators (TrISP)
ISSN
1524-4628 (Electronic)
ISSN-L
0039-2499
Publication state
Published
Issued date
03/2017
Peer-reviewed
Oui
Volume
48
Number
3
Pages
699-703
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
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.
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.
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).
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.

Keywords
Administration, Intravenous/methods, Aged, Aged, 80 and over, Brain Ischemia/complications, Brain Ischemia/drug therapy, Female, Fibrinolytic Agents/therapeutic use, Humans, Intracranial Hemorrhages/drug therapy, Intracranial Hemorrhages/etiology, Male, Middle Aged, Sex Characteristics, Stroke/complications, Stroke/drug therapy, Thrombolytic Therapy/methods, Tissue Plasminogen Activator/administration & dosage, Tissue Plasminogen Activator/therapeutic use, Treatment Outcome
Pubmed
Open Access
Yes
Create date
07/02/2017 17:58
Last modification date
20/08/2019 15:28
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