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Sex and Age Interactions and Differences in Outcomes After Intracerebral Hemorrhage.

Publication ,  Journal Article
James, ML; Cox, M; Xian, Y; Smith, EE; Bhatt, DL; Schulte, PJ; Hernandez, A; Fonarow, GC; Schwamm, LH
Published in: J Womens Health (Larchmt)
April 2017

BACKGROUND: Compared to ischemic stroke, sex differences in response to intracerebral hemorrhage (ICH) are largely unexplored, and their potential interactions with patient age have not been examined. This study hypothesized that risk for poor outcome is greater in women with increasing age. METHODS AND RESULTS: The Get With The Guidelines®-Stroke database was used to assess differences between men and women with ICH. Data from 192,826 ICH patients admitted from January 1, 2009 through March 31, 2014 to 1,728 fully participating sites were analyzed using logistic regression to test interactions between age/sex and outcome. RESULTS: In the total study population, 48.9% were women (median age 75; male median age 67). On admission, women over 65 years were less likely to have atrial fibrillation or dyslipidemia, or use antiplatelet therapy or cholesterol reducers, but more likely to suffer worse neurological deficit than men over 65. As age increased, odds of in-hospital mortality increased in both men and women, although the relationship was stronger in men. Odds of combined mortality and discharge to hospice were similar in men and women with increasing age, but odds for discharge to home and independent ambulation at discharge decreased more in women with increasing age. CONCLUSIONS: After adjusting for covariates, modest sex differences in early outcomes after ICH were linked to age. While statistically significant, detected interactions should be considered in context. Future study may examine whether sex-based interactions represent biologic or treatment differences, unmeasured covariates, or some combination thereof.

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Published In

J Womens Health (Larchmt)

DOI

EISSN

1931-843X

Publication Date

April 2017

Volume

26

Issue

4

Start / End Page

380 / 388

Location

United States

Related Subject Headings

  • United States
  • Stroke
  • Sex Factors
  • Sex Characteristics
  • Recovery of Function
  • Public Health
  • Prognosis
  • Outcome Assessment, Health Care
  • Neurologic Examination
  • Middle Aged
 

Citation

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James, M. L., Cox, M., Xian, Y., Smith, E. E., Bhatt, D. L., Schulte, P. J., … Schwamm, L. H. (2017). Sex and Age Interactions and Differences in Outcomes After Intracerebral Hemorrhage. J Womens Health (Larchmt), 26(4), 380–388. https://doi.org/10.1089/jwh.2016.5849
James, Michael L., Margueritte Cox, Ying Xian, Eric E. Smith, Deepak L. Bhatt, Phillip J. Schulte, Adrian Hernandez, Gregg C. Fonarow, and Lee H. Schwamm. “Sex and Age Interactions and Differences in Outcomes After Intracerebral Hemorrhage.J Womens Health (Larchmt) 26, no. 4 (April 2017): 380–88. https://doi.org/10.1089/jwh.2016.5849.
James ML, Cox M, Xian Y, Smith EE, Bhatt DL, Schulte PJ, et al. Sex and Age Interactions and Differences in Outcomes After Intracerebral Hemorrhage. J Womens Health (Larchmt). 2017 Apr;26(4):380–8.
James, Michael L., et al. “Sex and Age Interactions and Differences in Outcomes After Intracerebral Hemorrhage.J Womens Health (Larchmt), vol. 26, no. 4, Apr. 2017, pp. 380–88. Pubmed, doi:10.1089/jwh.2016.5849.
James ML, Cox M, Xian Y, Smith EE, Bhatt DL, Schulte PJ, Hernandez A, Fonarow GC, Schwamm LH. Sex and Age Interactions and Differences in Outcomes After Intracerebral Hemorrhage. J Womens Health (Larchmt). 2017 Apr;26(4):380–388.
Journal cover image

Published In

J Womens Health (Larchmt)

DOI

EISSN

1931-843X

Publication Date

April 2017

Volume

26

Issue

4

Start / End Page

380 / 388

Location

United States

Related Subject Headings

  • United States
  • Stroke
  • Sex Factors
  • Sex Characteristics
  • Recovery of Function
  • Public Health
  • Prognosis
  • Outcome Assessment, Health Care
  • Neurologic Examination
  • Middle Aged