Sex-related differences in stroke outcome at The University of Maiduguri Teaching Hospital, Northeastern Nigeria

Abstract

Background: Studies have reported sex differences in stroke risk factor, presentation, morbidity and mortality. This study aims to determine the effect of sex on morbidity and 30-day fatality in patients with acute stroke. Methods: Ninety-one patients were recruited for the study. We documented sex differences in stroke presentation, stroke severity on admission and discharge, and 30-day in-hospital fatality. Continuous variables were assessed using the student t-test. While outcome measures were analysed using the logistic regression analysis.

Results: There were 61 men (67%) and 30 women (33%) seen during the study period. Women were less likely to be formally educated (P = 0.024). Men were more likely to have lacunar strokes (P = 0.048), to smoke (P = 0.046) and take alcohol (P = 0.027). Men had a higher diastolic blood pressure at presentation (P = 0.046), even though they were more likely to be on antihypertensive medications pre-stroke (P = 0.036). Women were more likely to present with coma on presentation (P = 0.003), and suffer urinary tract infections (P = 0.023). Women were also more likely to have a severe stroke on admission (Barthel’s ADL < 45, odds ratio OR = 5.30; 95% CI, 1.10 to 25.62 and mRS > 4, OR = 5.38; 95% CI, 1.53 to 18.96) and a poorer activity of daily living (ADL) status on discharge (OR = 4.40; 95% CI, 1.45 to 13.35).

Conclusions: Sex differences in outcome exist in this study and women appear to have a poorer stroke outcome, more studies are needed to assess sex differences in response to therapy.