Ischaemic stroke in women and men – in-hospital prognosis

Introduction
Stroke is one of the most common causes of death and the leading cause of disability in the adult population worldwide. The risk of stroke increases with age in both men and women, but women have a higher rate of mortality and disability following stroke.

Aim of the research
To compare the in-hospital mortality in men and women with ischaemic stroke and to identify factors that predispose to death.

Material and methods
This retrospective, single-centre study included patients with acute ischaemic stroke hospitalized in the reference neurological centre in 2013–2014. The study population consisted of 2000 patients, of whom 50.5% were men. Data on age, sex, comorbidities, results of additional tests, and the course of hospitalization were analysed.

Results
In-hospital mortality was 15.9% and was higher in women than men (17.9% vs. 14%, p = 0.02). Women were older than men (77.3 vs. 69.5 years, p < 0.001). In women, age ≥ 75 years (OR = 2.507), chronic obstructive pulmonary disease (COPD) (OR = 2.231), and haemorrhagic transformation of the stroke site (OR = 4.77) increased the risk of in-hospital mortality. In men, a history of myocardial infarction (OR = 2.295) and a glomerular filtration rate (GFR) < 60 ml/min/1.73 m2 (OR = 1.774) increased the risk of in-hospital death.

Conclusions
Better knowledge of the predictors that increase the risk of an adverse stroke may open more avenues for preventive intervention and reduce serious post-stroke complications. Further observations on potential gender differences in risk factors for adverse prognosis in acute stroke are needed to reduce in-hospital deaths.