Mediators of sex-specific differences in rates of stroke mimics among patients treated with intravenous thrombolysis: A nationwide analysis of 174,995 patients

IF 2 4区医学 Q3 NEUROSCIENCES

Journal of Stroke & Cerebrovascular Diseases Pub Date : 2024-09-18 DOI:10.1016/j.jstrokecerebrovasdis.2024.108021

Huanwen Chen MD , Mihir Khunte BS , Marco Colasurdo MD , Seemant Chaturvedi MD , Ajay Malhotra MD , Dheeraj Gandhi MD

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引用次数: 0

Abstract

Introduction

Women are at higher risk of stroke mimics; however, the underlying reasons are unclear.

Methods

In this retrospective cohort study of the 2016–2020 National Inpatient Sample database, we identified patients treated with intravenous thrombolysis (IVT). Demographic information, vascular risk factors, comorbidities, and presence of known risk factors for stroke mimics (seizures, migraines, demyelinating diseases, psychiatric illnesses, and functional neurological disorders [FND]) were identified using ICD-10 codes. Rates of no cerebral infarction (NCI) were compared between men and women. Mediation analyses were conducted to identify significant drivers of sex-specific differences in the rate of NCI.

Results

174,995 IVT-treated patients were identified; 41,605 (23.8 %) had NCI. Female patients had significantly higher rates of NCI compared to men (26.2 % vs. 20.9 %, p < 0.001). Women had significantly higher rates of stroke mimic risk factors (seizures, migraines, demyelinating disease, anxiety, depression, FND, and electrolyte derangements; all p < 0.001). Mediation analyses revealed that 39.8 %, 19.1 % of female sex's association with higher rates of NCI were mediated by higher rates of migraines and FND among women, respectively (both p < 0.001).

Conclusions

IVT-treated women were more likely to have NCI than men. This relationship was largely mediated by higher rates of migraine and FND among women.

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在接受静脉溶栓治疗的患者中，中风模拟症状发生率的性别差异诱因：对 174995 名患者进行的全国性分析。

导言：女性患中风模拟症的风险更高，但其根本原因尚不清楚：在这项对 2016-2020 年全国住院患者抽样数据库进行的回顾性队列研究中，我们确定了接受静脉溶栓（IVT）治疗的患者。使用 ICD-10 编码确定了人口统计学信息、血管风险因素、合并症以及是否存在已知的卒中模拟风险因素（癫痫发作、偏头痛、脱髓鞘疾病、精神疾病和功能性神经紊乱 [FND]）。比较了男性和女性未发生脑梗塞（NCI）的比率。进行了中介分析，以确定NCI发生率性别差异的重要驱动因素：结果：174,995 名接受 IVT 治疗的患者中，41,605 人（23.8%）患有 NCI。女性患者的NCI发生率明显高于男性（26.2%对20.9%，P结论：接受IVT治疗的女性患者NCI发生率明显高于男性（26.2%对20.9%，P结论）：接受 IVT 治疗的女性患者比男性患者更容易出现 NCI。这种关系在很大程度上是因为女性偏头痛和FND的发病率较高。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Stroke & Cerebrovascular Diseases Medicine-Surgery

CiteScore

5.00

自引率

4.00%

发文量

583

审稿时长

62 days

期刊介绍： The Journal of Stroke & Cerebrovascular Diseases publishes original papers on basic and clinical science related to the fields of stroke and cerebrovascular diseases. The Journal also features review articles, controversies, methods and technical notes, selected case reports and other original articles of special nature. Its editorial mission is to focus on prevention and repair of cerebrovascular disease. Clinical papers emphasize medical and surgical aspects of stroke, clinical trials and design, epidemiology, stroke care delivery systems and outcomes, imaging sciences and rehabilitation of stroke. The Journal will be of special interest to specialists involved in caring for patients with cerebrovascular disease, including neurologists, neurosurgeons and cardiologists.