Sex Differences and Functional Outcome After Intravenous Thrombolysis

Publication

Sex Differences and Functional Outcome After Intravenous Thrombolysis

Journal Paper/Review - Jan 31, 2017

Spaander Fianne H, Leys Didier, Hochart Anais, Padjen Visnja, Kägi Georg, Pezzini Alessandro, Michel Patrik, Bill Olivier, Zini Andrea, Engelter Stefan T, Nederkoorn Paul J, Scheitz Jan F, Nolte Christian H, Zinkstok Sanne M, Baharoglu Irem M, Gensicke Henrik, Polymeris Alexandros, Traenka Christopher, Hametner Christian, Ringleb Peter, Curtze Sami, Martinez-Majander Nicolas, Aarnio Karoliina

Citation

Spaander F, Leys D, Hochart A, Padjen V, Kägi G, Pezzini A, Michel P, Bill O, Zini A, Engelter S, Nederkoorn P, Scheitz J, Nolte C, Zinkstok S, Baharoglu I, Gensicke H, Polymeris A, Traenka C, Hametner C, Ringleb P, Curtze S, Martinez-Majander N, Aarnio K. Sex Differences and Functional Outcome After Intravenous Thrombolysis. Stroke 2017; 48:699-703.

Type

Journal Paper/Review (English)

Journal

Stroke 2017; 48

Publication Date

Jan 31, 2017

Issn Electronic

1524-4628

Pages

699-703

Brief description/objective

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.