Sex Differences in Clinical Presentation of Women and Men Evaluated at a Comprehensive Stroke Center for Suspected Stroke.

IF 2 Q3 PERIPHERAL VASCULAR DISEASE

Cerebrovascular Diseases Extra Pub Date : 2025-01-01 Epub Date: 2025-02-12 DOI:10.1159/000543835

Jordi Kühne Escolà, Bessime Bozkurt, Bastian Brune, Lennart Steffen Milles, Doreen Pommeranz, Philipp Dammann, Yan Li, Cornelius Deuschl, Michael Forsting, Clemens Kill, Christoph Kleinschnitz, Martin Köhrmann, Benedikt Frank

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引用次数: 0

Abstract

Introduction: Understanding sex differences in the clinical presentation of patients with suspected stroke is important to reduce sex-related disparities and improve care. We aimed to characterize presenting symptoms in women and men with suspected stroke evaluated at our comprehensive stroke center.

Methods: This was a retrospective analysis of consecutive patients with suspected stroke treated at the University Hospital Essen between January 2017 and December 2021. Patient characteristics, signs and symptoms as well as final diagnoses in women and men were compared. Logistic regression analysis was performed to assess the association of individual symptoms with a diagnosis of cerebrovascular disease.

Results: We included 6,069 patients in our analysis. Cerebrovascular disease was diagnosed in 85.2% (2,576/3,022) of women and 88.0% (2,681/3,047) of men (p = 0.002). Aphasia (31.4% vs. 27.7%, p = 0.002), neglect (15.5% vs. 12.8%, p = 0.003), gaze deviation (21.0% vs. 18.8%, p = 0.034), as well as nonfocal symptoms including impairments in consciousness (17.0% vs 14.6%, p = 0.012), orientation (42.5 vs. 36.4%, p < 0.001), and completion of tasks (31.2% vs. 26.0%, p < 0.001) were more common among women. Limb ataxia (8.1% vs. 11.2%, p < 0.001) and dysarthria (44.0% vs. 46.8%, p = 0.030) were less frequent in women. Neglect and gaze deviation were independent positive predictors of cerebrovascular disease in women but not in men.

Conclusion: Although clinical presentation was similar in both sexes, cortical and nonfocal symptoms were more common among women with suspected stroke. Awareness of sex differences and acknowledgment of the full clinical picture are important to ensure optimal management for women and men with suspected stroke. Our findings might serve as a target for educational programs in order to improve preclinical stroke detection in patients with predominantly nonfocal or subtle symptoms.

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综合卒中中心对疑似卒中患者临床表现的性别差异进行评估。

简介：了解疑似中风患者临床表现的性别差异对减少性别差异和改善护理具有重要意义。我们的目的是描述在我们的综合卒中中心评估的疑似卒中的女性和男性的表现症状。方法：回顾性分析2017年1月至2021年12月在埃森大学医院连续治疗的疑似卒中患者。比较男女患者的特征、体征和症状以及最终诊断。采用Logistic回归分析评估个体症状与脑血管疾病诊断的相关性。结果：我们纳入了6069例患者。85.2%（2576/3022）的女性和88.0%（2681/3047）的男性被诊断为脑血管疾病（p = 0.002）。失语（31.4%比27.7%,p = 0.002）、忽视（15.5%比12.8%,p = 0.003）、凝视偏差（21.0%比18.8%,p = 0.034）以及非病灶性症状，包括意识障碍（17.0%比14.6%,p = 0.012）、定向（42.5%比36.4%,p < 0.001）和完成任务（31.2%比26.0%,p < 0.001）在女性中更为常见。肢体共济失调（8.1%比11.2%,p < 0.001）和构音障碍（44.0%比46.8%,p = 0.030）在女性中较少见。忽视和凝视偏差是女性脑血管疾病的独立阳性预测因子，而不是男性。结论：尽管两性的临床表现相似，但皮质性和非局灶性症状在疑似中风的女性中更为常见。对性别差异的认识和对临床全貌的认识对于确保对疑似中风的男女患者进行最佳管理至关重要。我们的研究结果可以作为教育计划的目标，以提高非局灶性或轻微症状患者的临床前卒中检测。

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

Cerebrovascular Diseases Extra PERIPHERAL VASCULAR DISEASE-

CiteScore

3.50

自引率

0.00%

发文量

审稿时长

8 weeks

期刊介绍： This open access and online-only journal publishes original articles covering the entire spectrum of stroke and cerebrovascular research, drawing from a variety of specialties such as neurology, internal medicine, surgery, radiology, epidemiology, cardiology, hematology, psychology and rehabilitation. Offering an international forum, it meets the growing need for sophisticated, up-to-date scientific information on clinical data, diagnostic testing, and therapeutic issues. The journal publishes original contributions, reviews of selected topics as well as clinical investigative studies. All aspects related to clinical advances are considered, while purely experimental work appears only if directly relevant to clinical issues. Cerebrovascular Diseases Extra provides additional contents based on reviewed and accepted submissions to the main journal Cerebrovascular Diseases.