133 Gender Differences in Mortality of Hospitalised Stroke Patients: A Systematic Review and Meta-Analysis

Abdel-Fattah, A R; Pana, T; Smith, T; Pasdar, Z; Aslam, M; Mamas, M; Myint, P

Abstract

Aim Gender differences in mortality after stroke remain unclear in the current literature. We therefore aimed to systematically review the gender differences in mortality up to five-years following ischaemic (IS) or haemorrhagic stroke(HS) to address this evidence gap. Method The literature was systematically searched using Ovid-EMBASE, Medline, and Web-of-Science databases, from inception to November-2021. The quality of evidence was appraised using the CASP Cohort-study checklist. Unadjusted and adjusted odds and hazard ratios were meta-analysed separately for IS and HS. Results Forty-one studies were included (n=8,128,700; mean-age: 68.5 years; 47.1% female). Thirty-seven studies were included in meta-analysis (n=8,8008,110). Compared to men, women who had IS had lower mortality-risk in-hospital (RR: 0.94; 95%CI: 0.91–0.97), at one-month (RR: 0.87; 95%CI: 0.77–0.98), 12-months (RR: 0.94; 95%CI: 0.91–0.98) and five-years (RR: 0.93 95%CI: 0.90–0.96). Nevertheless, analysis of crude data showed women were at higher risk of mortality in-hospital, at 12-months and five-years (in-hospital, RR: 1.05; 95%CI:1.03–1.07; 12-months, RR: 1.10; 95%CI: 1.06–1.14; five-years, RR: 1.06; 95%CI: 1.02–1.10). After HS, women had higher mortality-risk in-hospital (RR: 1.03; 95%CI: 1.01–1.04) however, no gender differences were found post-discharge. Conclusions The gender differences in post-stroke mortality differ by stroke type, age-group, and follow-up. Crude stroke mortality in women is higher than in men and this appears to be driven by pre-existing comorbidities. In adjusted models, women have a lower mortality-risk following IS, independent of duration of follow-up. After HS, women had higher mortality in hospital however, no gender differences after hospital discharge were found.

Citation

Abdel-Fattah, A. R., Pana, T., Smith, T., Pasdar, Z., Aslam, M., Mamas, M., & Myint, P. (2024). 133 Gender Differences in Mortality of Hospitalised Stroke Patients: A Systematic Review and Meta-Analysis. British Journal of Surgery, 111(Supplement_6), https://doi.org/10.1093/bjs/znae163.664

• Journal Article Type: Meeting Abstract
• Conference Name: ASiT Annual Conference 2024
• Conference Location: Bournemouth, UK
• Acceptance Date: Aug 29, 2024
• Online Publication Date: Aug 29, 2024
• Publication Date: Jul 3, 2024
• Deposit Date: Dec 13, 2024
• Journal: British Journal of Surgery
• Print ISSN: 0007-1323
• Publisher: Wiley
• Peer Reviewed: Peer Reviewed
• Volume: 111
• Issue: Supplement_6
• DOI: https://doi.org/10.1093/bjs/znae163.664
• Public URL: https://keele-repository.worktribe.com/output/920844