Sex Differences in Treatment and Prognosis of Acute Intracerebral Hemorrhage

Background: Intracerebral hemorrhage (ICH) accounts for 10%-15% of all stroke cases and is associated with a high risk of death and disability. Prior studies in ischemic stroke have demonstrated a less favorable outcome in women compared with men, but there is a paucity of data regarding differences in outcome by sex in ICH. The aim of the present study was to investigate possible sex differences in acute care and the 3-months follow-up of patients with ICH.Methods: Data were collected from the Swedish National Stroke Registry (Riksstroke). Demographic and baseline characteristics were collected, based on in-hospital data and data from 3-months follow-up.Results: Variables of interest were collected from 1,403 patients. Women (45.1%) were significantly older than men, with a mean age +/- standard deviation of 77 +/- 13years, versus 71 +/- 14 years, p < 0.01. On admission, the ICH severity was similar in men and women. There was no significant association between sex and reception of neuroimaging or neurosurgery. Women were less likely to be treated in a stroke unit (80.8% vs. 85.3%, p = 0.03), or discharged to home (51.5% vs. 63.4%, p < 0.01). At 3-months follow-up, there were no sex-related differences regarding dependence, post-ICH self-reported depression, or case fatality.Conclusions: Women were less likely to be treated in a stroke unit, and were less often discharged to home. However, no significant differences in 3-month functional outcome or survival between men and women with ICH were found in this study.

Automated summary

This study found gender differences in patients with intracerebral hemorrhage (ICH), with women being less likely to receive treatment in a stroke unit and less likely to be discharged home. However, there were no significant differences in functional outcome or survival between men and women at the 3-month follow-up.