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Published on: July 14, 2023
Gender differences in long-term functional outcome after first-ever ischemic stroke.
Michinari Fukuda1, Tadashi Kanda, Naoto Kamide
1Faculty of Rehabilitation, School of Allied Health Sciences, Kitasato University, Sagamihara. mifukuda@kitasato-u.ac.jp
Internal Medicine (Tokyo, Japan)
|June 16, 2009
Summary
Women experience worse long-term functional outcomes after ischemic stroke compared to men. These gender differences persist across all stroke subtypes and impact survival rates, highlighting a critical area for targeted research and intervention.
Area of Science:
- Neurology
- Public Health
- Gerontology
Background:
- Emerging evidence suggests gender disparities in post-stroke functional recovery.
- Previous research on the reasons behind these differences has yielded inconsistent findings.
- Understanding long-term outcomes is crucial for effective stroke management.
Purpose of the Study:
- To investigate gender differences in long-term functional outcomes after first-ever ischemic stroke.
- To analyze these differences across specific ischemic stroke subtypes.
- To assess the impact of gender on survival rates post-stroke.
Main Methods:
- A cohort of 997 patients (654 men, 343 women) with first-ever ischemic stroke were followed for 5 years.
- Patients were categorized into four stroke subtypes: atherothrombotic, lacunar, cardioembolic, and unclassified infarction.
- Locomotor activity was assessed via mail questionnaire at 1 and 5 years post-stroke, categorized into 5 disability grades.
Main Results:
- Women exhibited significantly poorer locomotor function than men at both 1 and 5 years post-stroke (p < 0.001 and p < 0.01).
- Gender-based functional outcome disparities were significant across all investigated ischemic stroke subtypes at both time points.
- Logistic regression confirmed gender as a significant predictor of functional outcome (p < 0.01 and p < 0.001).
- Women had a significantly worse survival ratio post-stroke (p < 0.01), with no significant gender difference in stroke recurrence rates.
Conclusions:
- Women consistently experience worse long-term functional outcomes compared to men following ischemic stroke.
- These significant gender-based differences in functional recovery are evident across all major ischemic stroke subtypes.
- The findings underscore the need to address gender-specific factors in stroke care and rehabilitation.
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Ischemic stroke is an acute cerebrovascular condition in which blood flow to a brain region is suddenly interrupted, leading to tissue infarction. Neurons depend on continuous oxygen and glucose supply, so even brief reductions in perfusion cause energy failure, ionic imbalance, and irreversible injury. Ischemic strokes are classified into thrombotic and embolic types based on their underlying mechanisms.Thrombotic MechanismsThrombotic stroke develops when a clot forms within a cerebral artery.
01:15Ischemic Stroke ll: Pathophysiology
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