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Sex differences in care and long-term mortality after stroke: Australian Stroke Clinical Registry

Phan, HT ORCID: 0000-0003-0506-2924, Gall, SL ORCID: 0000-0002-5138-2526, Blizzard, CL ORCID: 0000-0002-9541-6943, Lannin, NA, Thrift, AG, Anderson, CS, Kim, J, Grimley, R, Castley, HC, Hand, P and Cadilhac, DA 2019 , 'Sex differences in care and long-term mortality after stroke: Australian Stroke Clinical Registry' , Journal of Women's Health, vol. 28, no. 5 , pp. 712-720 , doi: 10.1089/jwh.2018.7171.

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Abstract

Introduction: There is some evidence that women receive evidence-based care less often than men, but how this influences long-term mortality after stroke is unclear. We explored this issue using data from a national stroke registry. Materials and Methods: Data are first-ever hospitalized strokes (2010-2014) in the Australian Stroke Clinical Registry from 39 hospitals linked to the national death registrations. Multilevel Poisson regression was used to estimate the women:men mortality rate ratio (MRR), with adjustment for sociodemographics, stroke severity, and processes of care (stroke unit care, intravenous thrombolysis, antihypertensive agent[s], and discharge care plan). Results: Among 14,118 events (46% females), women were 7 years older and had greater baseline severity compared to men (29% vs. 37%; p unadjusted 1.44, 95% confidence interval [CI] 1.34-1.54). However, there were no differences after adjusting for age and stroke severity (MRRadjusted 1.03, 95% CI 0.95-1.10). In analyses of additional processes from Queensland hospitals (n = 5224), women were less often administered aspirin ≤48 hours (61% vs. men 69%, p  Conclusion: Greater mortality in women can be explained by differences in age and stroke severity. This highlights the importance of better management of risk factors in the elderly and, potentially, the need for greater access to early aspirin for women with stroke.

Item Type: Article
Authors/Creators:Phan, HT and Gall, SL and Blizzard, CL and Lannin, NA and Thrift, AG and Anderson, CS and Kim, J and Grimley, R and Castley, HC and Hand, P and Cadilhac, DA
Keywords: quality of care, mortality, sex difference, stroke
Journal or Publication Title: Journal of Women's Health
Publisher: Mary Ann Liebert, Inc. Publishers
ISSN: 1540-9996
DOI / ID Number: 10.1089/jwh.2018.7171
Copyright Information:

Copyright 2019 Mary Ann Liebert, Inc.

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