Background: Although diverging, most studies show that sex has no significant influence on stroke
survival. Methods: In a Copenhagen, Denmark, community all patients with stroke during March 1992 to
November 1993 were registered on hospital admission. Stroke severity was measured
using the Scandinavian Stroke Scale (0-58); computed tomography determined stroke
type. A risk factor profile was obtained for all including ischemic heart disease,
hypertension, diabetes mellitus, atrial fibrillation, previous stroke, smoking, and
alcohol consumption. Date of death was obtained within a 10-year follow-up period.
Predictors of death were identified using a Cox proportional hazards model. Results: Of 999 patients, 559 (56%) were women and 440 (44%) were men. Women were older (77.0
v 70.9 years; P < .001) and had more severe strokes (Scandinavian Stroke Scale: 36.1 v 40.5; P < .001). Age-adjusted risk factors showed no difference between sexes for ischemic
heart disease, hypertension, atrial fibrillation, diabetes mellitus, and previous
stroke. Men more often were smokers and alcohol consumers. Unadjusted survival in
men and women did not differ: 70.3% versus 66.7% (1-year), 40.0% versus 38.9% (5-year),
and 17.4% versus 18.7% (10-year), respectively. Adjusting for age, stroke severity,
stroke type, and risk factors, women had a higher probability of survival at 1 year
(hazard ratio 1.47, 95% confidence interval 1.10-2.00); 5 years (hazard ratio 1.47,
95% confidence interval 1.23-1.76); and 10 years (hazard ratio 1.49, 95% confidence
interval 1.28-1.76). Before 9 months poststroke, no difference in survival was seen.
Severity of stroke had the same effect on sex. Conclusion: Stroke is equally severe in men and women. Short-term survival is the same. Having
survived stroke, women, however, live longer.
Key Words
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Journal of Stroke and Cerebrovascular DiseasesAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Short-term, intermediate-term, and long-term mortality in patients hospitalized for stroke.J Clin Epidemiol. 2003; 56: 81-87
- Stroke case fatality in Denmark from 1977 to 1992.Neuroepidemiology. 2002; 21: 22-27
- Trends in case-fatality of stroke in Finland during 1983 to 1992.Stroke. 1997; 28: 2493-2499
- Sex differences in first-ever acute stroke.Stroke. 2003; 34: 1581-1585
- Hospitalization and case fatality rates for stroke in Canada from 1982 through 1991.Stroke. 1996; 27: 1215-1220
- Sex differences in the clinical presentation, resource use, and 3-month outcome of acute stroke in Europe.Stroke. 2003; 34: 1114-1119
- Sex differences in management and outcome after stroke.Stroke. 2003; 34: 1970-1975
- Predicting functional outcome and survival after acute ischemic stroke.J Neurol. 2002; 249: 888-895
- Incidence, risk, and case fatality of first ever stroke in the elderly population.J Neurol Neurosurg Psychiatry. 2003; 74: 317-321
- Survival and recurrence after first cerebral infarction.Neurology. 1998; 50: 208-216
- Predicting survival for 1 year among different subtypes of stroke.Stroke. 1994; 25: 1935-1944
- Prognosis of stroke in the south of Greece.J Neurol Neurosurg Psychiatry. 2000; 69: 595-600
- Poor outcome after first-ever stroke.Stroke. 2003; 34: 122-126
- Registration of stroke through the Belgian sentinental network and factors influencing stroke mortality.Cerebrovasc Dis. 2003; 16: 272-279
- Trends in stroke incidence and 10-year survival in Söderham, Sweden, 1975-2001.Stroke. 2003; 34: 1353-1356
- Ten-year prognosis of stroke and risk factors for death in a Japanese community.Stroke. 2003; 34: 2343-2348
- Risk factors and 20-year stroke mortality in men and women in the Renfrew/Paisely study in Scotland.Stroke. 1999; 30: 1999-2007
- Cause-specific mortality after first cerebral infarction.Stroke. 2003; 34: 1828-1832
- Three-year survival and recurrence after stroke in Malmö, Sweden.Stroke. 1998; 29: 2114-2117
- Predicting survival after stroke.Stroke. 1998; 19: 669-673
- Risk and causes of death in a community-based stroke population.Neuroepidemiology. 1999; 18: 75-84
- Acute cerebrovascular disease in women.Eur Neurol. 2001; 45: 199-205
- High early case fatality after ischemic stroke in Poland.J Neurol Sci. 2002; 202: 53-57
- Stroke incidence, case fatality, and mortality in the WHO MONICA project.Stroke. 1995; 26: 361-367
- Long-term survival and causes of death after stroke.Stroke. 2001; 32: 2131-2136
- Impact of stroke type on survival and functional health.Cerebrovasc Dis. 2001; 12: 27-33
- Sex differences and similarities in the management and outcome of stroke patients.Stroke. 2000; 31: 1833-1837
- Survival and recurrence following stroke.Stroke. 1982; 13: 290-295
- Survival and functional status 20 or more years after first stroke.Stroke. 1998; 29: 793-797
- United Nations. United Nations Publications, New York, NY2000
- Risk factors.Stroke. 1997; 28: 1507-1517
- Sex differences in US mortality rates for stroke and stroke subtypes by race/ethnicity and age, 1995-1998.Stroke. 2002; 33: 1197-1201
- Marked increase of stroke incidence in men between 1972 and 1990 in Frederiksberg, Denmark.Stroke. 1992; 23: 1701-1704
- Recommendations on stroke prevention, diagnosis, and therapy.Stroke. 1989; 20: 1407-1431
- Multicenter trial of hemodilution in ischemic stroke–background and study protocol.Stroke. 1985; 16: 885-890
- Gender differences in management after acute myocardial infarction.J Public Health. 2004; 26: 259-263
Article info
Publication history
Accepted:
June 10,
2005
Received:
May 31,
2005
Identification
DOI: https://doi.org/10.1016/j.jstrokecerebrovasdis.2005.06.002
Copyright
© 2005 National Stroke Association. Published by Elsevier Inc. All rights reserved.
