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Gender difference in mortality among Hispanics hospitalized with acute ischaemic stroke in Puerto Rico

B Alanazi, M Aljodai, M Almutairi, J Acuna, S Aldaham, J Zevallos
Published in : HAMDAN MEDICAL JOURNAL ; Vol 8, No 4 (2015): Supplement Issue
DOI : 10.7707/hmj.581

Abstract


Introduction: Stroke is the fourth leading cause of death in Puerto Rico and is a major cause of adult disability. In the USA, Hispanics have a lower overall incidence of stroke than Whites and Blacks, but present with stroke at an earlier age, and have more frequent lacunar strokes. There are limited data in the published scientific literature about gender differences in mortality in Hispanics with acute ischaemic stroke (AIS).

Objectives: To study the association between gender and in-hospital mortality among patients with AIS living in Puerto Rico.

Materials and methods: A secondary analysis of the Puerto Rico Stroke Registry was conducted for 2007, 2009 and 2011. This was a non-concurrent cohort study and all cases were independently validated through the review of medical records. We conducted a descriptive analysis using the chi-squared test and independent sample t -test. Confounders were controlled for using multiple logistic regression.

Results: The overall sample size consisted of 1950 cases; 1017 (52.2%) were female. Mean age was 68.3 and 73.1 years for males and females, respectively. After adjusting for diabetes mellitus, hypertension, hyperlipidaemia and current smoking, males and females had the same risk of dying [odds ratio (OR)=1.37, 95% confidence interval (CI): 0.85 to 2.22]. There was no significant difference in mortality rate in participants who received tissue plasminogen activator (t-PA) among patients with AIS (OR=1.20, 95% CI: 0.46 to 3.11) However, for every year a patient with AIS gets older, the risk of dying increases by 4% (OR=1.04, 95% CI: 1.02 to 1.06). In addition, t-PA was similarly administered to males and females.

Conclusions: There was no association between gender and in-hospital mortality rate; however, the risk of dying after having AIS increases significantly every year a patient gets older. We recommend that older patients with stroke should receive enhanced care to reduce the risk of unwarranted death.

Acknowledgements: We would like to thank Professor Sulaiman Aba Al-Khail, Dr Khalid Alqumaize Naomie Jean, Grettel and Pura.


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