TY - JOUR
T1 - Biological Sex Differences in Risk Factors and Outcomes among Hospitalized Adults with Stroke in Lusaka, Zambia
AU - Nutakki, Aparna
AU - Chomba, Mashina
AU - Chishimba, Lorraine Chishimba
AU - Zimba, Stanley
AU - Gottesman, Rebecca F.
AU - Bahouth, Mona N.
AU - Saylor, Deanna R.
N1 - Funding Information:
This work was supported by the American Academy of Neurology Medical Student Research Scholarship, U.S. Department of State Fulbright Scholar Fellowship, and NIH [Grant Numbers: R21 NS118543-01, 1K01TW011771-01A1, and D43TW009340].
Funding Information:
A. Nutakki received the American Academy of Neurology Medical Student Scholarship and NIH Fogarty Fellowship [Grant Number D43TW009340]. L. Chishimba reports no disclosures relevant to the manuscript. M. Chomba reports no disclosures relevant to the manuscript. S. Zimba reports no disclosures relevant to the manuscript. R.F Gottesman reports no disclosures relevant to the manuscript. M. N. Bahouth received NIH Grant No. R21 NS118543-01. D. Saylor received the U.S. Department of State Fulbright Scholar Fellowship and NIH Grant No. 1K01TW011771-01A1. Go to Neurology.org/N for full disclosures.
Publisher Copyright:
© American Academy of Neurology.
PY - 2023/4/4
Y1 - 2023/4/4
N2 - ObjectiveWe investigated sex differences in clinical characteristics and outcomes among hospitalized adults with stroke in Zambia.MethodsWe retrospectively collected information for 324 consecutively hospitalized adults with stroke on the neurology service at the University Teaching Hospital in Lusaka, Zambia, between October 2018 and March 2019. Stroke characteristics were then compared by biological sex.ResultsFemale participants constituted 62% (n = 200) of the cohort, were older (61 ± 19 vs 57 ± 16 years, p = 0.06), had fewer hemorrhagic stroke than male participants (22% vs 37%, p = 0.001), and had higher rates of hypertension (84% vs 74%, p = 0.04), diabetes (19% vs 13%, p = 0.04), heart disease (38% vs 27%, p = 0.04), and history of stroke (26% vs 14%, p = 0.01). Male participants had higher rates of alcohol (33% vs 4%, p < 0.001) and tobacco (19% vs 2%, p < 0.001) use. Female participants were less likely to have neuroimaging completed during their hospitalization (82% vs 94%, p = 0.002) and had higher 90 days postdischarge mortality (28% vs 10%, p = 0.002) independent of age and stroke subtype (OR 2.48, 95% CI 1.1-5.58, p = 0.03).DiscussionFemale participants in this Zambian stroke cohort had a higher prevalence of vascular risk factors but were less likely to have neuroimaging completed. Postdischarge mortality was markedly higher among female participants even after adjusting for age and stroke subtype. Our data highlight the need for future studies of social and socioeconomic factors that may influence stroke-related outcomes.
AB - ObjectiveWe investigated sex differences in clinical characteristics and outcomes among hospitalized adults with stroke in Zambia.MethodsWe retrospectively collected information for 324 consecutively hospitalized adults with stroke on the neurology service at the University Teaching Hospital in Lusaka, Zambia, between October 2018 and March 2019. Stroke characteristics were then compared by biological sex.ResultsFemale participants constituted 62% (n = 200) of the cohort, were older (61 ± 19 vs 57 ± 16 years, p = 0.06), had fewer hemorrhagic stroke than male participants (22% vs 37%, p = 0.001), and had higher rates of hypertension (84% vs 74%, p = 0.04), diabetes (19% vs 13%, p = 0.04), heart disease (38% vs 27%, p = 0.04), and history of stroke (26% vs 14%, p = 0.01). Male participants had higher rates of alcohol (33% vs 4%, p < 0.001) and tobacco (19% vs 2%, p < 0.001) use. Female participants were less likely to have neuroimaging completed during their hospitalization (82% vs 94%, p = 0.002) and had higher 90 days postdischarge mortality (28% vs 10%, p = 0.002) independent of age and stroke subtype (OR 2.48, 95% CI 1.1-5.58, p = 0.03).DiscussionFemale participants in this Zambian stroke cohort had a higher prevalence of vascular risk factors but were less likely to have neuroimaging completed. Postdischarge mortality was markedly higher among female participants even after adjusting for age and stroke subtype. Our data highlight the need for future studies of social and socioeconomic factors that may influence stroke-related outcomes.
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U2 - 10.1212/WNL.0000000000201696
DO - 10.1212/WNL.0000000000201696
M3 - Article
C2 - 36535774
AN - SCOPUS:85151911592
SN - 0028-3878
VL - 100
SP - 666
EP - 669
JO - Neurology
JF - Neurology
IS - 14
ER -