Sex differences in clinical characteristics and 1-year outcomes of young ischemic stroke patients in East China

Geng, C.; Lin, Yapeng; Tang, Qin; Tang, Yifang; Wang, Xiaoqing; Zhou, Junshan; Yang, Jie; Zheng, Danni; Zhang, Yingdong

doi:10.2147/tcrm.s182232

Cited by 11 publications

(14 citation statements)

References 21 publications

(34 reference statements)

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“…Knowledge on post-stroke outcomes with regard to sex may lead to beneficial interventions to improve neurologic outcome after stroke. It is important to note that in adult patients with AIS, even after adjusting the analysis for other factors, women have worse outcomes than men [ 18 , 25 , 31 , 32 ]. A recent study presented by Geng et al [ 32 ], including 228 young adult (18–50 years old) AIS patients from Eastern China, proved the female sex to be a risk factor for both death at the acute phase of the disease and dependency 12 months from the stroke onset.…”

Section: Discussionmentioning

confidence: 99%

Does the Occurrence of Particular Symptoms and Outcomes of Arterial Ischemic Stroke Depend on Sex in Pediatric Patients?—A Pilot Study

et al. 2020

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Arterial ischemic stroke (AIS) in childhood is reported to occur more frequently in boys, which may lead to the assumption that the prevalence of post-stroke deficits is sex related. The present study aimed to evaluate sex-related differences in functional outcomes (hemiparesis, seizures, aphasia, and motor disturbances other than hemiparesis) in pediatric patients with AIS. A total of 89 children (52 boys and 37 girls; mean age at stroke onset: 8.4 ± 5.6 years) were evaluated retrospectively based on data from medical records. The patients were divided into subgroups according to age (i.e., infants and toddlers, children, and adolescents), stroke subtype (i.e., lacunar anterior circulation infarct (LACI), total anterior circulation infarct (TACI), partial anterior circulation infarct (PACI), posterior circulation infarct (POCI)) and stroke location (i.e., anterior stroke, posterior stroke). Significant differences in the prevalence of stroke subtypes between girls and boys were observed (p = 0.034). POCI stroke were found to be more frequent in boys than in girls (OR = 8.57 95%CI 1.05–70.23, p = 0.023). Males predominated in the total group and in all analyzed age subgroups. The proportions of boys within the subgroups according to stroke subtype were extremely high for the POCI and TACI stroke subgroups. On the other hand, girls predominated in the LACI stroke subgroup. Frequency of central type facial nerve palsy and other symptoms of AIS were found to significantly differ between male subgroups according to stroke subtype (p = 0.050 and p < 0.001, respectively), as well as between children with anterior stroke and those with posterior stroke (p = 0.059 and p < 0.001, respectively). Post-stroke seizures appeared significantly more commonly in girls with TACI and POCI stroke than in girls with LACI and PACI stroke (p = 0.022). In turn, the prevalence of post-stroke hemiparesis differed between stroke subtypes in boys (p = 0.026). In conclusion, sex may have an impact in predisposing to a certain type of AIS in the patient. Post-stroke seizure may be related to stroke subtype in girls and hemiparesis in boys. However, further studies are needed to confirm the results.

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Section: Discussionmentioning

confidence: 99%

Does the Occurrence of Particular Symptoms and Outcomes of Arterial Ischemic Stroke Depend on Sex in Pediatric Patients?—A Pilot Study

et al. 2020

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“…Previous studies have observed that the baseline characteristics of patients with stroke are associated with the subsequent development of depression symptoms [28] : for example, female stroke survivors are reportedly more likely to be dead or dependent at 12 months following stroke onset, [29] and high baseline NIHSS scores are associated with an increased risk of neurological and medical complications. [30] Some authors have postulated that such characteristics at baseline might, therefore, predict poor outcomes of patients following stroke.…”

Section: Discussionmentioning

confidence: 99%

Persistent depression is a predictor of quality of life in stroke survivors

Yao

Guan

et al. 2019

Chinese Medical Journal

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Background:Whether the time course of post-stroke depression (PSD) can be used to predict the quality of life (QoL) of patients with late-stage stroke remains unclear, this study investigated whether persistent depression at 1 year after stroke predicts QoL at 5 years following stroke.Methods:We analyzed the demographic and clinical data of patients with stroke in 56 hospitals across China that participated in the Prospective Cohort Study on the Incidence and Outcome of Patients with PSD in China Study. Follow-up assessments were performed at the following time points after stroke: in person, 2 weeks, 3 months, 6 months, and 1 year; by telephone, 5 years. National Institutes of Health Stroke Scale (NIHSS) score on admission, recurrence, disability, depression, QoL, and chronic complications were recorded. Depression was diagnosed using the Diagnostic and Statistical Manual of Mental Disorders. QoL was measured using short form-12 (SF-12). Multivariable ordinal logistic regression analysis was used to identify factors that independently affected the physical component summary (PCS) and mental component summary (MCS) scores of the SF-12.Results:Of the 801 patients evaluated in this study, 80 had persistent depression. The multivariable regression analysis of data obtained at 5 years showed that persistent depression at 1 year (odds ratio [OR]: 0.48; 95% confidence interval [CI]: 0.29–0.81) and disability at 5 years (OR: 0.34; 95% CI: 0.23–0.49) were associated with poor MCS scores at 5 years. Old age, a high NIHSS score on admission, disability at 5 years, and stroke recurrence within 5 years were associated with poor PCS scores at the 5-year follow-up.Conclusions:Persistent depression at the 1-year follow-up could predict poor MCS scores at the 5-year follow-up. The development of interventional strategies targeting post-stroke patients with persistent depression is warranted.

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“…In Chinese young adults with AIS aged below 50 years, young women had poorer outcomes defined as having a modified Rankin Scale score of 3–6 at 12 months. Except for the female sex, the National Institutes of Health Stroke Scale (NIHSS) score and pneumonia were reported as independent factors for poor outcome [ 74 ]. The authors also observed systolic blood pressure at admission to be significantly lower in women than in men [ 74 ].…”

Section: Poststroke Outcome According To Sexmentioning

confidence: 99%

“… Summary of the literature review on the frequency of AIS occurrence [ 6 , 25 , 43 , 44 ], stroke location [ 4 , 59 , 60 ], stroke symptoms [ 4 , 9 , 59 ], and poststroke outcomes [ 4 , 69 , 71 , 74 , 75 ] according to sex in both paediatric patients and young adults; AIS—arterial ischemic stroke; LACI—lacunar anterior circulation infarct; TACI—total anterior circulation infarct; PACI—partial anterior circulation infarct; POCI—posterior circulation infarct. …”

Section: Figurementioning

confidence: 99%

The Impact of Sex on Arterial Ischemic Stroke in Young Patients: From Stroke Occurrence to Poststroke Consequences

Sarecka-Hujar

Kopyta

2021

Children

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The male sex has been suggested to predominate in paediatric patients with arterial ischemic stroke (AIS), especially in newborns. The explanation for this phenomenon remains unsatisfactory since it focuses on the analysis of the potential relationship with trauma and arterial dissection. In turn, in some populations of young adults, men suffer from AIS more frequently than women, which may be related to the protective role of oestrogen. On the other hand, certain data indicate that women dominate over men. Some of the disparities in the frequencies of particular symptoms of AIS and poststroke consequences in both children and young adults have been suggested; however, data are scarce. Unfortunately, the low number of studies on the subject does not allow certain conclusions to be drawn. For adults, more data are available for patients aged over 60 years, the results of which are more obvious. The present literature review aimed to discuss available data on the prevalence of AIS, its clinical presentations, and poststroke consequences in regard to the sex of young patients. We considered young patients to be children from birth up to the age of 19 years of life and young adults to be individuals up to the age of 55 years. The role of sex hormones in AIS and possible gender differences in genetic risk factors for AIS were also discussed briefly.

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Sex differences in clinical characteristics and 1-year outcomes of young ischemic stroke patients in East China

Cited by 11 publications

References 21 publications

Does the Occurrence of Particular Symptoms and Outcomes of Arterial Ischemic Stroke Depend on Sex in Pediatric Patients?—A Pilot Study

Does the Occurrence of Particular Symptoms and Outcomes of Arterial Ischemic Stroke Depend on Sex in Pediatric Patients?—A Pilot Study

Persistent depression is a predictor of quality of life in stroke survivors

The Impact of Sex on Arterial Ischemic Stroke in Young Patients: From Stroke Occurrence to Poststroke Consequences

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