Temporal trends of sex differences in acute reperfusion therapy and early outcomes of acute ischemic stroke in South Korea: 10-year analysis of the nationwide stroke registry.

IF 6.3 2区 医学 Q1 CLINICAL NEUROLOGY International Journal of Stroke Pub Date : 2024-10-01 Epub Date: 2024-07-24 DOI:10.1177/17474930241261877
Darda Chung, Ji Sung Lee, Mi-Sun Oh, Jong-Moo Park, Jong-Won Chung, Oh Young Bang, Gyeong-Moon Kim, Woo-Keun Seo
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Abstract

Background: Sex differences in stroke outcomes are notable, with women experiencing higher incidence rates, greater disability-adjusted life years, and poorer recovery compared to men, even after adjusting for age and comorbidities. Despite the disproportionate burden in women, studies have reported that women are less likely to receive appropriate stroke treatment than men.

Aim: This study investigated temporal trends of sex differences in acute reperfusion therapy and early outcomes in patients with acute ischemic stroke over 10 years in South Korea.

Methods: A retrospective analysis of Korean Stroke Registry included patients with acute ischemic stroke from 2012 to 2021. The study outcomes were the temporal trends of acute reperfusion therapy and early outcomes over 10 years in men and women, respectively. In addition, this study analyzed the temporal trends of sex differences in these parameters during the same period. Early outcomes include the proportions of favorable functional outcomes at discharge, discharge patterns, and in-hospital mortality.

Results: A total of 93,692 patients (68.4 years, 40.1% women) with acute ischemic stroke were finally enrolled. Women had a higher age at stroke onset, a higher prevalence of atrial fibrillation, and more severe strokes than men. Women had lower proportion of favorable functional outcomes at discharge and higher proportion of in-hospital mortality compared to men each year. The proportion of patients who received intravenous thrombolysis was lower or similar in women compared to men in most years, and the proportion of patients who received endovascular thrombectomy did not significantly differ between sexes annually. Sex differences in acute reperfusion therapy remained unchanged over 10 years.

Conclusion: Women have received acute reperfusion therapy at similar or lower rates than men and experienced poorer outcomes, despite having more stroke risk factors and often more severe strokes.

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韩国急性再灌注治疗和急性缺血性脑卒中早期预后的性别差异时间趋势:全国脑卒中登记处的十年分析。
背景:与男性相比,女性的发病率更高、残疾调整生命年数更长、恢复更差,即使在调整年龄和合并症后也是如此。目的:本研究调查了韩国急性缺血性卒中患者急性再灌注治疗和早期预后 10 年来的性别差异时间趋势:方法:对韩国卒中登记处进行回顾性分析,纳入 2012 年至 2021 年的急性缺血性卒中患者。研究结果显示,男性和女性急性再灌注治疗和早期预后的时间趋势分别为 10 年。此外,本研究还分析了同期这些参数的性别差异时间趋势。早期预后包括出院时良好功能预后的比例、出院模式和院内死亡率:共有 93,692 名急性缺血性脑卒中患者(68.4 岁,40.1% 为女性)最终入选。与男性相比,女性中风发病年龄更高,心房颤动发生率更高,中风程度更严重。与男性相比,女性出院时获得良好功能预后的比例较低,每年的院内死亡率较高。在大多数年份中,女性与男性相比接受静脉溶栓治疗的比例较低或相似,而每年接受血管内血栓切除术的患者比例在性别上没有显著差异。急性再灌注治疗的性别差异在10年中保持不变:结论:女性接受急性再灌注治疗的比例与男性相似或更低,尽管她们有更多的中风风险因素,中风程度往往也更严重,但她们的治疗效果却更差。
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来源期刊
International Journal of Stroke
International Journal of Stroke 医学-外周血管病
CiteScore
13.90
自引率
6.00%
发文量
132
审稿时长
6-12 weeks
期刊介绍: The International Journal of Stroke is a welcome addition to the international stroke journal landscape in that it concentrates on the clinical aspects of stroke with basic science contributions in areas of clinical interest. Reviews of current topics are broadly based to encompass not only recent advances of global interest but also those which may be more important in certain regions and the journal regularly features items of news interest from all parts of the world. To facilitate the international nature of the journal, our Associate Editors from Europe, Asia, North America and South America coordinate segments of the journal.
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