Sex differences in incidence, mortality, and survival in individuals with stroke in Scotland, 1986 to 2005

Lewsey, J.D. et al. (2009) Sex differences in incidence, mortality, and survival in individuals with stroke in Scotland, 1986 to 2005. Stroke, 40(4), pp. 1038-1043. (doi: 10.1161/STROKEAHA.108.542787)

Abstract

<p><b>Background and Purpose:</b> The aim of this study was to examine the effect of sex across different age groups and over time for stroke incidence, 30-day case-fatality, and mortality.</p> <p><b>Methods:</b> All first hospitalizations for stroke in Scotland (1986 to 2005) were identified using linked morbidity and mortality data. Age-specific rate ratios (RRs) for comparing women with men for both incidence and mortality were modeled with adjustment for study year and socioeconomic deprivation. Logistic regression was used to model 30-day case-fatality.</p> <p><b>Results:</b> Women had a lower incidence of first hospitalization than men and size of effect varied with age (55 to 64 years, RR=0.65, 95% CI 0.63 to 0.66; 85 years, RR=0.94, 95% CI 0.91 to 0.96). Women aged 55 to 84 years had lower mortality than men and again size of effect varied with age (65 to 74 years, RR=0.79, 95% CI 0.76 to 0.81); 75 to 84 years, RR=0.94, 95% CI 0.92 to 0.95). Conversely, women aged 85 years had 15% higher stroke mortality than men (RR=1.15, 95% CI 1.12 to 1.18). Adjusted risk of death within 30 days was significantly higher in women than men, and this difference increased over the 20-year period in all age groups (adjusted OR in 55 to 64 year olds 1.23, 95% CI 1.14 to 1.33 in 1986 and 1.51, 95% CI 1.39 to 1.63 in 2005).</p> <p><b>Conclusions:</b> We observed lower rates of incidence and mortality in younger women than men. However, higher numbers of older women in the population mean that the absolute burden of stroke is greater in women. Short-term case-fatality is greater in women of all ages and, worryingly, these differences have increased from 1986 to 2005.</p>

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Lewsey, Professor Jim and McMurray, Professor John and Walters, Professor Matthew and MacIntyre, Dr Kate and Langhorne, Professor Peter and Jhund, Professor Pardeep and Briggs, Professor Andrew and Gillies, Dr Michelle
• Authors: Lewsey, J.D., Gillies, M., Jhund, P.S., Chalmers, J.W.T., Redpath, A., Briggs, A.H., Walters, M., Langhorne, P., Capewell, S., McMurray, J.J.V., and MacIntyre, K.
• College/School: College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Public Health; College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Health Economics and Health Technology Assessment; College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health; College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Mental Health and Wellbeing; College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
• Journal Name: Stroke
• Publisher: American Heart Association
• ISSN: 0039-2499
• ISSN (Online): 1524-4628
• Published Online: 10 February 2009
• Copyright Holders: Copyright © 2009 American Heart Association
• First Published: First published in Stroke 40(4):1038-1043
• Publisher Policy: Reproduced in accordance with the copyright policy of the publisher