4.6 Article

Sex and Age Differences in Patient-Reported Acute Stroke Symptoms

Journal

FRONTIERS IN NEUROLOGY
Volume 13, Issue -, Pages -

Publisher

FRONTIERS MEDIA SA
DOI: 10.3389/fneur.2022.846690

Keywords

stroke; signs and symptoms; sex diferences; prehospital delay time; behavior

Funding

  1. TrygFonden [128669]
  2. Novo Nordisk Foundation Borregaard stipend [NNF18OC0031840]

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This study aimed to explore the differences in typical and atypical symptoms reported by stroke patients based on their sex and age. The results showed that female patients and younger patients were more likely to present with atypical symptoms. The findings suggest the importance of recognizing these atypical first presentations in order to facilitate early stroke treatment.
BackgroundIdentification of sex- and age-related differences in the presentation of atypical symptoms at stroke onset may reduce prehospital delay and improve stroke treatment if acknowledged at first contact. AimTo explore sex- and age-related differences in patient-reported typical and atypical symptoms of a stroke. MethodsWe used data from a cross-sectional survey at two non-comprehensive stroke units in the Capital Region of Denmark. Patient-reported symptoms, stroke knowledge, and behavioral response were analyzed by the Chi-square test or a Fisher's exact test separated by sex. Multivariable logistic regression adjusted for covariates were used to explore sex- and age-related differences according to each patient-reported typical or atypical symptoms. ResultsIn total, 479 patients with acute stroke were included (median age 74 years [25th to 75th percentile: 64-80], and 40.1% were women). Female sex was associated with higher odds of presenting with atypical symptoms, such as loss of consciousness (OR 2.12 [95% CI 1.08-4.18]) and nausea/vomiting (OR 2.33 [95% CI 1.24-4.37]), and lower odds of presenting with lower extremity paresis (OR 0.59 [95% CI 0.39-0.89). With each year of age, the odds decreased of presenting with sensory changes (OR 0.95 [95% CI 0.94-0.97]) and upper extremity paresis (OR 0.98 [95% CI 0.96-0.99]), whereas odds of presenting with dysphagia (OR 1.06 [95% CI 1.02-1.11]) increased. ConclusionsPatients of female sex and younger age reported on admission more frequently atypical stroke symptoms. Attention should be drawn to this possible atypical first presentation to facilitate correct identification and early stroke revascularization treatment to improve the outcome for both sexes.

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