Gender differences in stroke are matters of increasing interest. The American Stroke Association's patient management tool, Get with the Guidelines-Stroke (GGS) is widely used to increase adherence to quality indicators in stroke care, but it also provides an opportunity to analyze gender differences in the acute stroke setting.
We used a state-wide database, based on GGS, to explore gender differences in stroke in Colorado. We analyze demographics, risk factors, lifestyles, treatments, and responses to treatment.
Of 126 data elements examined, statistically significant gender differences were noted for 47 (37%). As compared to men, women in Colorado were older and more significantly impacted by acute stroke. Risk factor profiles differed between the 2 genders, with men having a higher incidence of coronary artery disease, dyslipidemia, diabetes, carotid stenosis and tobacco smoking, while women had a higher incidence of atrial fibrillation and hypertension. Lipids were less aggressively treated and antithrombotics were less commonly used in women. Overall, acute stroke treatment of women appeared "less aggressive" than for men.
GGS may be used not only for quality improvement initiatives in individual hospitals. It can also give an overview of clinical aspects of stroke at a state level, and may shed light on gender differences.
Data provided are for informational purposes only. Although carefully collected, accuracy cannot be guaranteed. The impact factor represents a rough estimation of the journal's impact factor and does not reflect the actual current impact factor. Publisher conditions are provided by RoMEO. Differing provisions from the publisher's actual policy or licence agreement may be applicable.
"M.K. Kapral et al. / Women's Health Issues 21-2 (2011) 171–176 174 revascularization and lipid management observed in multiple previous studies of patients with myocardial infarction (Abramson Bierman et al., 2009; Jneid et al., 2008; Saposnik et al., 2009) as well as stroke (Lewsey et al., 2009; Reeves et al., 2009; Smith et al., 2009). Of note, recent work from our group suggests that some of the observed gender differences in carotid revascularization may be explained by appropriate patient selection based on stroke characteristics, surgical eligibility, and the prevalence of severe carotid stenosis (Kapral, Ben-Yakov, et al., 2009) For both women and men, older age was associated with lower rates of use of warfarin for atrial fibrillation, statin use, carotid imaging, and carotid endarterectomy, and higher rates of dysphagia screening and consultations from rehabilitation services, findings that are consistent with previous research (Fairhead & Rothwell, 2006; Kaplan et al., 2005). "
[Show abstract][Hide abstract] ABSTRACT: Studies of potential gender differences in stroke care and outcomes have yielded inconsistent findings. The Project for an Ontario Women's Health Evidence-based Report study measured established stroke care indicators in a large, representative sample of women and men with stroke or transient ischemic attack (TIA) admitted to acute care institutions in the province of Ontario, Canada.
The Registry of the Canadian Stroke Network performs a biennial audit on a random sample of 20% of patients with stroke or TIA seen at more than 150 acute care institutions across Ontario. We used data from the 2004/05 audit to compare stroke care by gender, with stratification by age and neighborhood income.
The sample consisted of 4,046 patients (51% women). There were no significant gender differences in the use of thrombolysis, neuroimaging, carotid imaging, dysphagia screening, antithrombotic therapy, or neurology and other consultations. Women with ischemic stroke or TIA were less likely than men to be prescribed statins or undergo carotid imaging and endarterectomy within 6 months of stroke; women were more likely than men to receive antihypertensives. There were no significant gender differences in readmission or mortality rates after stroke.
In this population-based study, we found little evidence of gender differences in stroke care or outcomes other than lipid-lowering therapy, carotid imaging, and endarterectomy. Further study is needed to assess the contribution of the provincial stroke strategy in eliminating gender differences in management of acute stroke and to better understand and target remaining gender differences in management.
Full-text · Article · Dec 2010 · Women s Health Issues
"Stroke is the major cause of adult disability worldwide.1,2 Although it is known that there are gender differences in various factors of stroke, such as risk factors, clinical manifestations, mortalities, and functional outcomes, they have received attention only recently.3-5 Gender differences in stroke are worthy of investigation because female stroke patients-who have a higher prevalence of stroke due to a longer life expectancy-will be a greater burden to our society than male stroke patients.6 "
[Show abstract][Hide abstract] ABSTRACT: PurposezzInterest in gender differences in the effects of acute stroke is growing worldwide. However, gender differences in functional recovery after acute stroke in the Korean population have yet to be evaluated. The aim of this investigation was to compare long-term functional outcomes between male and female after acute stroke.
Patients with acute stroke were enrolled prospectively between January 2005 and January 2009. Baseline characteristics, risk factors, stroke subtypes, time delay from onset to arrival at a hospital, active treatment, and stroke severity were compared between male and female. Differences in mortality and disability at discharge, and at 3 months and 1 year after stroke onset were also investigated. Functional disabilities were categorized into two groups: good outcome (score on modified Rankin scale ≤2) and poor outcome (score on modified Rankin scale >2).
Among 1,055 patients with acute stroke, 575 were male (aged 64.83±11.98 years, mean±SD) and 480 were female (aged 70.09±13.02 years). There were no gender differences in mortality at 3 months and 1 year after stroke. The frequency of poor outcomes was higher in female patients than in male patients at discharge (39.8% versus 30.9%, respectively; p=0.003), the 3 months follow-up (32.3% versus 20.8%, respectively; p<0.001), and the 1 year follow-up (31.1% versus 18.7%, respectively; p=0.001). After adjusting for multiple confounding factors including age and stroke severity, the female gender persisted as a predictor of poor functional outcome at 3 months and 1 year after stroke.
Female patients have greater difficulty than male patients in recovering from a disabled state after acute stroke. Future studies should investigate the causes of this gender difference.
Preview · Article · Dec 2010 · Journal of Clinical Neurology
[Show abstract][Hide abstract] ABSTRACT: This paper defines and illustrates a methodology to compare
specific telecommunications technologies (such as dedicated non-switched
lines, circuit switching, packet switching, frame relay, cell relay, and
Switched Multimegabit Data Service) that can be employed to support
data, voice and video information transfers among geographically
dispersed sites. The methodology yields a high level comparison of
telecommunications technologies whereby it is possible to establish the
potential ability of each technology to support specific traffic types
and communications modes. An example, using specific traffic profiles
and telecommunications technologies, is shown to demonstrate the
usefulness of the methodology. The paper concludes by recommending
additional actions that need to be undertaken in order to ultimately
select one or more telecommunications technologies that can support the
specific requirements of a communications system
Hans-Christoph Diener, James Aisenberg, Jack Ansell, Dan Atar, Günter Breithardt, John Eikelboom, Michael D. Ezekowitz, Christopher B. Granger, Jonathan L. Halperin, Stefan H. Hohnloser, Elaine M. Hylek, Paulus Kirchhof, Deirdre A. Lane, Freek W.A. Verheugt, Roland Veltkamp, Gregory Y.H. Lip