[Women and strokes. Hospital epidemiology in Spain]

Although in clinical practice no distinction is usually made in the prevention and management of strokes according to the sex of the patient, some studies suggest the existence of significant clinical differences in the strokes suffered by females.

The purpose of our study was to confirm and characterize these differences in patients admitted to hospitals in our community; to do so, we performed an analysis of the stroke or little stroke patients included in the Spanish Neurology Society's Stroke Database (BADISEN), from 1996 to 2001, belonging to eight Spanish hospitals. We analyzed the social aspects, risk factors, clinical features, diagnostic data, situation and referral on discharge of 4,248 female patients (39%). A univariate and, later, a multivariate analysis were performed using logistic regression of the variables that showed significant differences (p<0.2).

The findings from our study confirm a number of differences between male and female stroke victims. Strokes occur later in females (71 years old compared with 69 in males), when the patient lives alone. The following also occur more frequently in these patients than in males: arterial hypertension (62.8 versus 51.9%, p<0.0001), cardiac insufficiency (8.0 as opposed to 4.5%, p<0.0001) and atrial fibrillation (21.4 versus 11.3%, p<0.0001) as risk factors; cardioembolic causation (22.4 against 15.4%, p<0.0001) in anterior circulation (44.0 compared to 36.1%, p<0.0001); severity is increased (6.8 on the Canadian scale versus 7.5%, p<0.0001); more medical complications (40.5 compared to 33.7%, p<0.0001), more serious sequelae (64.2 on the Barthel index compared to 72.9%, p<0.0001) and a higher institutionalization rate, among other distinguishing facts.

Such differences must be taken into account in the prevention and management of strokes in females.