Sex-related time-dependent variations in post-stroke survival--evidence of a female stroke survival advantage

Neuroepidemiology. 2007;29(3-4):218-25. doi: 10.1159/000112464. Epub 2007 Dec 13.

Abstract

Background: Women live longer than men, yet most studies show that gender has no influence on survival after stroke.

Methods: A registry was started in 2001, with the aim of registering all hospitalized stroke patients in Denmark, and it now holds 39,484 patients of which 48% are female. We studied the influence of gender on post-stroke mortality, from the time of admission through the subsequent years until death or censoring (mean follow-up time: 538 days). All patients underwent an evaluation including stroke severity, computed tomography and cardiovascular risk factors. Independent predictors of death were identified by means of a survival model based on 22,222 individuals with a complete data set.

Results: Females were older and had severer stroke. Interestingly, the risk of death between genders was time dependent. The female/male stroke mortality rate favoured women from the first day of stroke and remained so during the first month suggesting a female survival advantage. Throughout the second month the rate reversed in favour of men suggesting that women in that period are paying a 'toll' for their initial survival advantage. Hereafter, the rate steadily decreased, and after 4 months women continued to have the same low risk as in the first week.

Conclusions: Our study suggests a female superiority in stroke survival competence.

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Cause of Death
  • Cerebral Hemorrhage / mortality
  • Denmark
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Mathematical Computing
  • Middle Aged
  • Patient Admission / statistics & numerical data
  • Proportional Hazards Models
  • Recurrence
  • Registries
  • Risk Factors
  • Sex Ratio*
  • Stroke / mortality*
  • Survival Analysis