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Sex as predictor for achieved health outcomes and received care in ischemic stroke and intracerebral hemorrhage: a register-based study.

Artikel i vetenskaplig tidskrift
Författare Carl Willers
Ingrid Lekander
Elisabeth Ekstrand
Mikael Lilja
Hélène Pessah-Rasmussen
Katharina S Sunnerhagen
Mia von Euler
Publicerad i Biology of sex differences
Volym 9
Nummer/häfte 1
Sidor 11
ISSN 2042-6410
Publiceringsår 2018
Publicerad vid Institutionen för neurovetenskap och fysiologi, sektionen för klinisk neurovetenskap
Sidor 11
Språk en
Länkar dx.doi.org/10.1186/s13293-018-0170-...
www.ncbi.nlm.nih.gov/entrez/query.f...
Ämneskategorier Neurologi, Hälso- och sjukvårdsorganisation, hälsopolitik och hälsoekonomi

Sammanfattning

Differences in stroke care and health outcomes between men and women are debated. The objective of this study was to explore the relationship between patients' sex and post-stroke health outcomes and received care in a Swedish setting.Patients with a registered diagnosis of acute intracerebral hemorrhage (ICH) or ischemic stroke (IS) within regional administrative systems (ICD-10 codes I61* or I63*) and the Swedish Stroke Register during 2010-2011 were included and followed for 1 year. Data linkage to multiple other data sources on individual level was performed. Adjustments were performed for age, socioeconomic factors, living arrangements, ADL dependency, and stroke severity in multivariate regression analyses of health outcomes and received care. Health outcomes (e.g., survival, functioning, satisfaction) and received care measures (regional and municipal resources and processes) were studied.Study population: 13,775 women and 13,916 men. After case-mix adjustments for the above factors, we found women to have higher 1-year survival rates after both IS (ORfemale = 1.17, p < 0.001) and ICH (ORfemale = 1.65, p < 0.001). Initial inpatient stay at hospital was, however, shorter for women (βfemale, IS = - 0.05, p < 0.001; βfemale, ICH = - 0.08, p < 0.005). For IS, good function (mRS ≤ 2) was more common in men (ORfemale = 0.86, p < 0.001) who also received more inpatient care during the first year (βfemale = - 0.05, p < 0.001).A lower proportion of women had good functioning, a difference that remained in IS after adjustments for age, socioeconomic factors, living arrangements, ADL dependency, and stroke severity. The amount of received hospital care was lower for women after adjustments. Whether shorter hospital stay results in lower function or is a consequence of lower function cannot be elucidated. One-year survival was higher in men when no adjustments were made but lower after adjustments. This likely reflects that women were older at time of stroke, had more severe strokes, and more disability pre-stroke-factors that make a direct comparison between the sexes intricate.

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Denna text är utskriven från följande webbsida:
http://www.gu.se/forskning/publikation/?publicationId=265134
Utskriftsdatum: 2020-02-21