Gender differences and woman-specific trends in acute stroke: Results from a hospital-based registry (1986–2009)

Abstract Objective We assessed gender differences and women-specific secular trends in stroke. Methods Data from 2318 women and 2274 men with first-ever stroke collected from the Sagrat Cor Hospital Stroke Registry of Barcelona between 1986 and 2009 were analyzed. Results Patient's age increased significantly from a mean of 74.5 years in 1986–1992 to 81.2 years in 2004–2009 ( P < 0.001). Patients aged ≥85 years increased from 18.5% to 38.5% ( P = 0.0001) as were patients with hypertension, atrial fibrillation, and cardioembolic stroke. The in-hospital death decreased from 17.6% to 11% ( P = 0.02), median length of hospital from 14 to 9 days ( P = 0.0001) and prolonged hospital stay (>12 days) from 59.7% to 33.7% ( P = 0.0001). Lacunar infarction was more frequent in men (21.5% vs. 16.2%, P = 0.0003) and cardioembolic infarction in women (26% vs. 15.6%, P = 0.0001). Acute stroke in women continues to be a severe disease with high risk of death in the immediate post-stroke phase (13.5%) and low probability of early full neurological recovery (13.9% vs. 11.8%, P = 0.029). Conclusion Women differ from men in the distribution of risk factors and stroke subtype, stroke severity, and outcome. An increase in the patient's age, hypertension, atrial fibrillation and cardioembolic infarction, as well as a decrease mortality and length of hospitalization over a 24-year period was recorded.