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Sex as predictor for achieved health outcomes and received care in ischemic stroke and intracerebral hemorrhage: a register-based study
Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden; Karolinska Institutet Stroke Research Network at Södersjukhuset, Stockholm, Sweden; Ivbar Institute AB, Stockholm, Sweden.
Ivbar Institute AB, Stockholm, Sweden; Medical Management Centre, Karolinska Institutet, Solna, Sweden.
Department of Health Sciences, Lund University, Lund, Sweden.
Department of Public Health and Clinical Medicine, Unit of Research, Education and Development, Östersund, Umeå University, Umeå, Sweden.
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2018 (English)In: Biology of Sex Differences, ISSN 2042-6410, Vol. 9, no 1, article id 11Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Differences in stroke care and health outcomes between men and women are debated. The objective of this study was to explore the relationship between patients' sex and post-stroke health outcomes and received care in a Swedish setting.

METHODS: Patients with a registered diagnosis of acute intracerebral hemorrhage (ICH) or ischemic stroke (IS) within regional administrative systems (ICD-10 codes I61* or I63*) and the Swedish Stroke Register during 2010-2011 were included and followed for 1 year. Data linkage to multiple other data sources on individual level was performed. Adjustments were performed for age, socioeconomic factors, living arrangements, ADL dependency, and stroke severity in multivariate regression analyses of health outcomes and received care. Health outcomes (e.g., survival, functioning, satisfaction) and received care measures (regional and municipal resources and processes) were studied.

RESULTS:  = - 0.05, p < 0.001).

CONCLUSIONS: A lower proportion of women had good functioning, a difference that remained in IS after adjustments for age, socioeconomic factors, living arrangements, ADL dependency, and stroke severity. The amount of received hospital care was lower for women after adjustments. Whether shorter hospital stay results in lower function or is a consequence of lower function cannot be elucidated. One-year survival was higher in men when no adjustments were made but lower after adjustments. This likely reflects that women were older at time of stroke, had more severe strokes, and more disability pre-stroke-factors that make a direct comparison between the sexes intricate.

Place, publisher, year, edition, pages
BioMed Central, 2018. Vol. 9, no 1, article id 11
Keywords [en]
Epidemiology, Health outcomes, Resources, Sex, Stroke, Utilization
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Medical and Health Sciences Endocrinology and Diabetes
Identifiers
URN: urn:nbn:se:oru:diva-80576DOI: 10.1186/s13293-018-0170-1ISI: 000427179000001PubMedID: 29514685Scopus ID: 2-s2.0-85043239706OAI: oai:DiVA.org:oru-80576DiVA, id: diva2:1414239
Available from: 2020-03-12 Created: 2020-03-12 Last updated: 2024-01-02Bibliographically approved

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