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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

Authors

A R Abdel-Fattah

T Pana

T Smith

Z Pasdar

M Aslam

P Myint



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. 133 Gender Differences in Mortality of Hospitalised Stroke Patients: A Systematic Review and Meta-Analysis. Presented at ASiT Annual Conference 2024, Bournemouth, UK

Presentation Conference Type Conference Abstract
Conference Name ASiT Annual Conference 2024
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
Electronic ISSN 1365-2168
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