330 Gender Differences in Mortality After Stroke in Thai Patients. a National Cohort Study

Abdel-Fattah, AR; Pana, T; Tiamkao, S; Sawanyawisuth, K; Kasemsap, N; Mamas, M; Myint, P

Abstract

Aim Gender differences in patients hospitalised with stroke is a major public health concern carrying important implications to service provision. There has not yet been a study specifically focussing on patients in Thailand. We aimed to assess the gender differences in mortality following ischaemic-stroke (IS) and haemorrhagic-stroke (HS) in a large Thai-cohort. Method All stroke admissions of patients between 2004–2015 were included from a Thai national-insurance database. The association between gender and mortality by stroke-type was assessed at one, 12 and 60-months using multivariable Cox-regression models. Results There were 543,763 patients included women made up 46.6% of patients with IS (n=172,800) and 41.3% of patients with HS (n=69,828). Women were older than men in both IS and HS groups (mean age:67.1, SD(13.4) vs. 64.1(12.9) and 64.2(14.3) vs. 59.1(13.9)), respectively. Women had higher prevalence of comorbidities and stroke-specific risk factors compared to men. When comparing mortality by stroke-type, mortality was higher in women post-IS at one-month (HR:1.17, 95%CI:1.15–1.20), one-year (HR:1.10, 95%CI:1.09–1.12) and five-years follow-up (HR:1.02, 95%CI:1.01–1.03). Similarly, mortality post-HS was also higher in women at all three follow-up timepoints (one-month HR:1.08, 95%CI:1.06–1.10, one-year HR:1.04, 95%CI:1.03–1.06, and five-years HR:1.09, 95% CI:1.08–1.11). Conclusions In Thai patients hospitalised with stroke, women have a greater burden of stroke-specific risk factors. The mortality outcome of women with stroke is consistently higher than that of men, which appears to be irrespective of stroke-type or duration following stroke, up to five-years after discharge. Whether this difference is attributable to differences in management or physiology warrants further evaluation.

Citation

Abdel-Fattah, A., Pana, T., Tiamkao, S., Sawanyawisuth, K., Kasemsap, N., Mamas, M., & Myint, P. (2022). 330 Gender Differences in Mortality After Stroke in Thai Patients. a National Cohort Study. British Journal of Surgery, 109(Supplement_6), https://doi.org/10.1093/bjs/znac269.226

• Journal Article Type: Article
• Acceptance Date: Aug 19, 2022
• Online Publication Date: Aug 19, 2022
• Publication Date: Aug 19, 2022
• Deposit Date: Aug 17, 2023
• Journal: British Journal of Surgery
• Print ISSN: 0007-1323
• Publisher: Wiley
• Peer Reviewed: Peer Reviewed
• Volume: 109
• Issue: Supplement_6
• DOI: https://doi.org/10.1093/bjs/znac269.226
• Keywords: Surgery