Association of sex and age with in‐hospital mortality and complications of patients with intracerebral hemorrhage: A study from the Chinese Stroke Center Alliance

Abstract

Background and purpose:The impact of sex and age on prognosis in patients with intracerebral hemorrhage (ICH) in the Chinese population remains unclear. Our study aimed to investigate the relationship between sex and age of Chinese ICH patients and adverse prognosis. Methods:We used the Chinese Stroke Center Alliance database with in-hospital mortality as the primary outcome and hospital complications as the secondary outcome.Patients were divided into four groups by sex and age. Logistic regression analyses were performed to assess the association between sex and age and the prognosis of ICH patients. Results:We enrolled 60,911 ICH patients, including 22,284 young and middle-aged males, 15,651 older males, 11,948 young and middle-aged females, and 11,028 older females. After adjusting for variables, older male patients had a higher mortality rate (OR = 1.21, 95% CI 1.01-1.45), combined with more frequent hematoma expansion (OR = 1.14, 95% CI 1.03-1.26), pneumonia (OR = 1.91, 95% CI 1.81-2.03), and hydrocephalus (OR = 1.28, 95% CI 1.04-1.59). Young and middle-aged female patients had a lower mortality rate (OR = 0.74, 95% CI 0.58-0.95) and less frequent combined pneumonia (OR = 0.81, 95% CI 0.75-0.87). In-hospital mortality was not significantly different in older females compared with young and middle-aged males, but the odds of deep vein thrombosis, swallowing disorders, urinary tract infections, and gastrointestinal bleeding were significantly higher. Conclusion:Among young and middle-aged patients, females are related to a lower in-hospital mortality rate from ICH. Older patients are at an increased risk of ICH complications, with higher in-hospital mortality in older men.

In-Hospital Mortality in Patients with and without Dementia across Age Groups, Clinical Departments, and Primary Admission Diagnoses

“…Therefore, the impact of dementia and the disease-associated risk factors and complications on mortality can change with age, probably having a more pronounced effect on mortality in younger ages where the general mortality rate is lower and the likelihood of infections and complications, as explained above, is higher as compared to the patients without dementia at the same age. In line with this, the possibility for in-hospital complications in the general population grows with increasing age [15]. Thus, our results revealed that the interplay of various health conditions and their relative contributions to in-hospital mortality can shift throughout aging, and the causes of death in individuals with dementia may vary at different age groups.…”

“…Therefore, the overall in-hospital mortality rate of this study (14%) aligns with these studies. Older individuals generally exhibit higher susceptibility to diseases, complications, and functional impairments, significantly affecting their survival probability [15]. The presence of multiple chronic conditions, as is the case in patients with dementia diseases [16], causes a decline in physiological reserve, contributing to the complexity of handling in-hospital treatment and care in this population group.…”

Sex differences in profile and in-hospital mortality for acute stroke in Chile: data from a nationwide hospital registry

“…Significantly, this distinction was noted during a productive phase of life, especially among individuals aged 55 and older. While conflicting results shown elsewhere 6–8,17,25 may stem from differences in methodologies, there may also be sociocultural explanations. 25,26 Women in our study where twice as likely to belong to a lower SES than men, and although this was controlled in the multivariable analysis, it is important to note that disadvantaged women are more susceptible to gender-based violence, social isolation, poor social support, and insufficient education than men.…”

“…Awareness is growing of sex differences in stroke, with studies consistently showing women are older at presentation, have more atrial fibrillation (AF) and hypertension (HT), and poorer functional outcomes. [2][3][4] There are divergent results in regard sex disparities in case fatality, [5][6][7][8] where most studies have been undertaken in developed countries, leaving a knowledge gap in relation to low-and middle-income countries where the influence of specific socioeconomic factors is likely to be important. Thus, our aim was to determine sex-differences in characteristics and determinants of in-hospital mortality for patients with acute stroke, using the nationwide hospital database of Chile.…”