Study On Gender Differences In Risk Factors And Prognosis Of Ischemic Stroke

Background:Stroke is a group of diseases characterized by high disability and mortality in clinic.In recent years;the morbidity of stroke remains high in China,which is the primary cause of death and disability in adults.There are gender differences in epidemiology,risk factors and socio-economic factors of stroke,which may have different affects on the prognosis of the male and female groups.Objective:To research the gender of differences in epidemiology,risk factors,socioeconomic factors and prognosis of stroke can help to formulate individualized disease prevention,treatment and nursing strategies for stroke patients of different genders.Methods:According to the "Stroke Secondary Prevention Cross-sectional studies and Standardized Therapy Study(SMART)",3249 patients with acute cerebral infarction were enrolled in 47 centers.Among them,2216 in males and 1033 in females.The data collected included hypertension,diabetes mellitus,coronary heart disease,atrial fibrillation,hyperlipidemia,smoking history,BMI(body mass index),education level,medical expenditure,and applying the National Institutes of Health Stroke Scale(NIHSS)of National Health Research Institute of the United States to assess the baseline severity of stroke,and the modified Rankin Scale(mRS)to assess the severity and prognosis of stroke.Results:The average age of female patients is older than that of male patients.The proportion of female patients with hypertension,diabetes,coronary heart disease and atrial fibrillation is higher than that of male patients.The proportion of smoking in male patients is much higher than that in female patients.The proportion of educated level in male patients is higher than that in female patients.The proportion of male patients participating in medical insurance is higher than that in female patients.At the time of four weeks and six weeks after onset,the proportion of female patients with adverse functional outcomes was higher than that of male patients.Factors associated with adverse outcomes in male patients were age([OR=1.030,95%(1.006,1.055)]),stroke severity([OR=1.366/95%(1.321,1.413)]),diabetes([OR=1.369;95%(1.324,1.416)]),coronary heart disease([OR=0.338,95%(0.121,0.943)]),atrial fibrillation([OR=0.330,95%(0.135,0.810)]).Factors associated with adverse outcomes in female patients were age([OR=1.035;95%(1.014,1.056)]),stroke severity([OR=1.264,95%(1.315,1.450)]),diabetes([OR=1.497,95%(1.022,2.192)]),coronary heart disease([OR=2.327,95%(1.065,5.085)]),self-paying medical([OR=2.094,95%(1.252,3-504)]),lower level education([OR=2.424,95%(1.139,5.157)]).The gender is not correlated with the outcomes of when discharge or 4 weeks,6 weeks and 6 monthes after onset.Conclusion:In patients with ischemic stroke,the proportion of female patients with hypertension,diabetes,coronary heart disease and atrial fibrillation is higher than that of male patients.The proportion of obesity and smoking in male patients is higher than that in female patients.Male patients are more educated than female patients,and the proportion of participating in health insurance is higher than that of female patients.The gender is not correlated with the outcomes of when discharge or four weeks and six weeks after onset.