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Diferencias de sexo en la mortalidad y los resultados funcionales en subtipos de accidente cerebrovascular: un
Tae Jung Kim1,2, Ji Sung Lee3, Jun Yup Kim4
1Department of Neurology, Seoul National University College of Medicine, Seoul, Republic of Korea.
Resumen
Las mujeres experimentan una menor mortalidad por accidente cerebrovascular pero resultados funcionales variables en comparación con los hombres. La personalización de la atención del accidente cerebrovascular por sexo y subtipo es crucial para mejorar la prevención secundaria y la rehabilitación.
Área de la Ciencia:
- Neurología
- Salud Pública
- Epidemiología
Sus antecedentes:
- Las disparidades de sexo en los resultados de los accidentes cerebrovasculares están bien documentadas.
- Es esencial comprender estas diferencias en todos los subtipos de accidentes cerebrovasculares y su vínculo con la atención aguda.
Objetivo del estudio:
- Investigar las diferencias de sexo en la mortalidad, los resultados funcionales y el manejo agudo del accidente cerebrovascular.
- Análisis de los subtipos de accidente cerebrovascular isquémico (IS), hemorragia intracerebral (ICH) y hemorragia subaracnoidea (SAH).
- Utilización de una cohorte nacional basada en la población para obtener información integral.
Principales métodos:
- Estudio de cohorte retrospectivo de 58,429 pacientes con accidente cerebrovascular agudo (2018-2021).
- Vinculación de datos de auditoría clínica y reclamaciones del Programa Nacional de Evaluación de la Calidad de Accidentes Cerebrovasculares Agudos de Corea del Sur.
- Modelos de regresión multivariante ajustados por edad, gravedad y comorbilidades para evaluar las disparidades de resultados basadas en el sexo.
Principales resultados:
- Las mujeres tuvieron una mortalidad ajustada significativamente menor en todos los subtipos de accidente cerebrovascular (IS, ICH, SAH).
- Los resultados funcionales variaron según el subtipo: peores para las mujeres en IS, mejores en ICH y similares en SAH.
- Se observaron diferencias basadas en el sexo en la utilización de la atención aguda (reperfusión, cirugía, rehabilitación), pero no explicaron completamente las disparidades en los resultados.
Conclusiones:
- Los resultados de los accidentes cerebrovasculares muestran disparidades de sexo significativas que difieren según el subtipo de accidente cerebrovascular.
- Si bien las mujeres tienen una menor mortalidad, la recuperación funcional no es consistentemente mejor.
- Enfatiza la necesidad de estrategias específicas de sexo y subtipo en la atención, prevención y rehabilitación de los accidentes cerebrovasculares.
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