Incidence and Outcomes of Hemorrhagic Stroke among Adults in Spain (2016–2018) According to Sex: A Retrospective, Cohort, Observational, Propensity Score Matched Study

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Miguel Yanes, Jose M. de and López de Andrés, Ana and Jiménez García, Rodrigo and Hernández Barrera, Valentín and Miguel Díez, Javier de and Méndez Bailón, Manuel and Pérez Farinós, Napoleón and Muñoz Rivas, Nuria and Carabantes Alarcón, David and López Herranz, Marta (2021) Incidence and Outcomes of Hemorrhagic Stroke among Adults in Spain (2016–2018) According to Sex: A Retrospective, Cohort, Observational, Propensity Score Matched Study. Journal of Clinical Medicine, 10 (16). p. 3753. ISSN 2077-0383

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Official URL: https://doi.org/10.3390/jcm10163753




Abstract

(1) Background: We aim to analyze sex differences in the incidence, clinical characteristics and in-hospital outcomes of hemorrhagic stroke (HS) in Spain (2016–2018) using the National Hospital Discharge Database.
(2) Methods: Retrospective, cohort, observational study. We estimated the incidence of HS in men and women. We analyzed comorbidity, treatments, procedures, and hospital outcomes. We matched each woman with a man by age, type of HS and medical conditions using propensity score matching.
(3) Results: HS was coded in 57,227 patients aged ≥18 years (44.3% women). Overall, men showed higher incidence rates (57.3/105 vs. 43.0/105; p < 0.001; IRR = 1.60; 95% CI: 1.38–1.83). Women suffered more subarachnoid hemorrhages (25.2% vs. 14.6%), whereas men more often had intracerebral hemorrhages (55.7% vs. 54.1%). In-hospital mortality (IHM) was higher for intracerebral hemorrhage in both men and women. Women underwent decompressive craniectomy less often than men (5.0% vs. 6.2%; p < 0.001). After matching, IHM among women was higher (29.0% vs. 23.7%; p < 0.001). Increments in age, comorbidity and use of anticoagulants and antiplatelet agents prior to hospitalization were associated were higher IHM, and decompressive craniectomy was associated with lower IHM in both sexes. After multivariable adjustment, women had higher IHM (OR = 1.23; 95% CI: 1.18–1.28).
(4) Conclusion: Men had higher incidence rates of HS than women. Women less often underwent decompressive craniectomy. IHM was higher among women admitted for HS than among men.


Item Type:Article
Uncontrolled Keywords:hemorrhagic stroke; sex differences; decompressive craniectomy; in-hospital mortality
Subjects:Medical sciences > Medicine > Cardiology
Medical sciences > Medicine > Hematology
ID Code:71284
Deposited On:28 Mar 2022 13:45
Last Modified:30 Mar 2022 08:10

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