Factors contributing to sex differences in functional outcomes and participation after stroke

• Tipo: Artigo em Revista Científica Internacional
• Data: 2018

Autores

Phan, HT (Autor) Outra; Blizzard, CL (Autor) Outra; Reeves, MJ (Autor) Outra; Thrift, AG (Autor) Outra; Cadilhac, DA (Autor) Outra; Sturm, J (Autor) Outra; Heeley, E (Autor) Outra; Otahal, P (Autor) Outra; Vemmos, K (Autor) Outra; Anderson, C (Autor) Outra; Parmar, P (Autor) Outra; Krishnamurthi, R (Autor) Outra; Barker Collo, S (Autor) Outra; Feigin, V (Autor) Outra; Bejot, Y (Autor) Outra; Cabral, NL (Autor) Outra; Carolei, A (Autor) Outra; Sacco, S (Autor) Outra; Chausson, N (Autor) Outra; Olindo, S (Autor) Outra; Rothwell, P (Autor) Outra; silva, mc (Autor) Outra; Correia, M (Autor) Outra; Magalhaes, R (Autor) ICBAS; Appelros, P (Autor) Outra; Korv, J (Autor) Outra; Vibo, R (Autor) Outra; Minelli, C (Autor) Outra; Gall, SL (Autor) Outra

Revista

Título: Neurology

Vol. 90

ISSN: 0028-3878

Editora: Wolters Kluwer Health

Indexação

ISI Web of Knowledge - 44 Citações

Scopus - 47 Citações

Outras Informações

ID Authenticus: P-00P-2RG

DOI: 10.1212/wnl.0000000000005602

Abstract (EN): Objective To examine factors contributing to the sex differences in functional outcomes and participation restriction after stroke. Methods Individual participant data on long-term functional outcome or participation restriction (i.e., handicap) were obtained from 11 stroke incidence studies (1993-2014). Multivariable logbinomial regression was used to estimate the female: male relative risk (RR) of poor functional outcome (modified Rankin Scale score > 2 or Barthel Index score < 20) at 1 year (10 studies, n = 4,852) and 5 years (7 studies, n = 2,226). Multivariable linear regression was used to compare the mean difference (MD) in participation restriction by use of the London Handicap Scale (range 0-100 with lower scores indicating poorer outcome) for women compared to men at 5 years (2 studies, n = 617). For each outcome, study-specific estimates adjusted for confounding factors (e.g., sociodemographics, stroke-related factors) were combined with the use of random-effects meta-analysis. Results In unadjusted analyses, women experienced worse functional outcomes after stroke than men (1 year: pooled RR(unadjusted)1.32, 95% confidence interval [CI] 1.18-1.48; 5 years: RRunadjusted 1.31, 95% CI 1.16-1.47). However, this difference was greatly attenuated after adjustment for age, prestroke dependency, and stroke severity (1 year: RRadjusted 1.08, 95% CI 0.97-1.20; 5 years: RRadjusted 1.05, 95% CI 0.94-1.18). Women also had greater participation restriction than men (pooled MDunadjusted -5.55, 95% CI -8.47 to -2.63), but this difference was again attenuated after adjustment for the aforementioned factors (MDadjusted -2.48, 95% CI -4.99 to 0.03). Conclusions Worse outcomes after stroke among women were explained mostly by age, stroke severity, and prestroke dependency, suggesting these potential targets to improve the outcomes after stroke in women.

Idioma: Inglês

Tipo (Avaliação Docente): Científica

Nº de páginas: 9