Post stroke review: gender-specific influences on long-term outcome (a Sino-Australian study).

Abstract

INTRODUCTION/BACKGROUND: The focus of post stroke review has shifted to identifying the significance of individual risk factors in predicting long-term disability. This study aimed to evaluate gender-specific patterns of stoke in terms of risk, incidence and symptom presentation. Overall, 30% of Australians report persistent disability after stroke. This continuing international, collaborative study aims to identify the frequency of long-term problems post stroke by gender within an Australian and Chinese population using the Post Stroke Checklist (PSC). METHOD: This study trials the PSC (endorsed by the World Stroke Organization) which identifies the incidence of 11 common sequelae after stroke with a focus on patient functioning and suggests appropriate courses of action. The study administered the PSC to 183 patients recruited from three acute stroke units at 6 months post stroke. RESULTS: Participants comprised 122 (66.7%) males and 61 (33.3%) females with a collective mean age of 64.73 years (SD = 13.8). Overall 82.5% patients reported at least one deficit at 6 months; with a higher incidence amongst females (86.9%) compared to males (80.3%), although non-significant. The pattern of symptoms between males and females however is similar. Females were more inclined to report long-term cognitive difficulties (59.0% compared to 36.9% of males) (chi square = 8.07, p<0.01, Odds ratio = 2.46, 95% Confidence Interval (CI) = 1.31 - 4.62) mobility limitations (50.8% to 36.95), pain (23.0% to 11.5% - trending towards significance; p = .070), difficulties performing activities of daily living (50.8% to 41.0%) and communication (29.5% to 23.8%). In the Chinese population, mobility limitation in females were markedly higher than the remainder of the group. CONCLUSION: In this study, the incidence of long-term sequelae of stroke had a gender bias. Females are over twice as likely to report long-term cognitive difficulties and had increased pain and difficulties with communication and performing activities of daily living.