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Lower hazard ratio for death in women with cerebral hemorrhage

K Shigematsu1, Y Watanabe2, H Nakano3

  • 1Department of Neurology, National Hospital Organization, Minami Kyoto Hospital, Kyoto, Japan.

Acta Neurologica Scandinavica
|February 4, 2015
PubMed

Insights

Women with cerebral hemorrhage (CH) have a lower 30-day mortality risk after stroke compared to men. This finding is significant across various consciousness levels, highlighting sex differences in stroke outcomes.

Area of Science:

  • Neurology
  • Public Health
  • Epidemiology

Background:

  • Stroke is a leading cause of death and disability worldwide.
  • Understanding sex-based differences in stroke outcomes is crucial for targeted interventions.
  • Previous studies have shown varying results regarding mortality differences between men and women after stroke.

Purpose of the Study:

  • To determine the hazard ratio (HR) for 30-day mortality in women compared to men following stroke.
  • To analyze these differences across major stroke subtypes: cerebral infarction (CI), cerebral hemorrhage (CH), and subarachnoid hemorrhage (SAH).
  • To investigate the influence of consciousness level at stroke onset on sex-based mortality differences.

Main Methods:

  • Retrospective analysis of 13,788 stroke patients from the Kyoto Stroke Registry (1999-2009).
  • Cox regression analysis was used to calculate hazard ratios (HR) for 30-day mortality, adjusted for key risk factors.
  • Patients were stratified by stroke subtype and consciousness level using the Japan Coma Scale (JCS).

Main Results:

  • Overall, no significant difference in 30-day mortality between women and men after stroke (HR 1.04).
  • Women with cerebral hemorrhage (CH) showed significantly lower 30-day mortality compared to men (HR 0.53, P < 0.01).
  • This reduced mortality in women with CH persisted across all Japan Coma Scale (JCS) levels.

Conclusions:

  • Women with cerebral hemorrhage (CH) experience a lower risk of 30-day mortality post-stroke compared to men.
  • Sex-based differences in stroke outcomes are subtype-specific.
  • Further research into the biological and clinical factors underlying these sex differences in CH outcomes is warranted.
Abstract

Keywords:
cerebrovascular diseasesneuroepidemiologysex, early outcomestrokes

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