Abstract P401: Female Gender is a Significant Risk Factor for Functional Disability after Hemorrhagic Stroke but Not Ischemic Stroke among Japanese Community-Dwelling Elderly Individuals

Kozo Tanno,Shuko Takahashi,Yuki Yonekura,Masaki Ohsawa,Shinichi Omama,Yasuhiro Ishibashi,Kazuyoshi Itai,Toshiyuki Onoda,Toru Kuribayashi,Kuniaki Ogasawara,Fumitaka Tanaka,Motoyuki Nakamura,Makoto Koshiyama,Kiyomi Sakata,Akira Okayama

Circulation（2019）SCI 1区

Cited 0|Views65

Abstract

Introduction: Previous studies have indicated that the female gender is one of the important risk factors for disability after stroke; however, most studies have been conducted in Western countries, and the higher risk of disability after stroke observed in women is thought to be different in Japan, where the proportion of hemorrhagic stroke (HS) is relatively higher than that in Western countries. Hypothesis: We assessed the hypothesis that the higher risk of disability after stroke attributable to the female gender was different between ischemic stroke (IS) and HS. Methods: We used 10-year community-based cohort data of 8,698 participants aged 65 years or older without cardiovascular disease or long-term care insurance (LTCI) at the time of the baseline survey. The stroke incidence was confirmed by reviewing the Iwate Stroke Registry. Functional disability was defined as being newly certified by the LTCI system. Participants were classified into three groups: G1, event-free (no stroke and no disability, n=7,950); G2, no disability after stroke (IS=177, HS=55); and G3, disability after stroke (IS=346, HS=170). Multivariate-adjusted odds ratios (ORs) of the female gender in G2 and G3 (reference: G1) were calculated using multinomial logistic regression with adjustments for age, hypertension, diabetes, dyslipidemia, overweight, current smoking, regular alcohol consumption, and regular exercise separately in those with IS and HS. Results: The ORs of the female gender were not high in G3 in IS, while the OR (95% confidence interval) was significantly high in G3 (1.55 (1.03-2.34)) in HS (see table). Conclusions: The proportion of females in the subjects with disabilities after HS was significantly higher than the proportion of males after multivariate adjustment. This suggested that the female gender was a significant risk factor for disability after HS, but not after IS in Japanese community-dwelling individuals.

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【要点】：研究发现在日本社区居住的老年人中，女性性别是出血性中风后功能障碍的显著风险因素，但在缺血性中风中则不是。

【方法】：利用10年的社区队列数据，对8,698名65岁及以上无心血管疾病或长期护理保险的参与者进行分析，通过多因素调整的多元逻辑回归计算女性性别在缺血性中风和出血性中风后功能障碍中的比值比（OR）。

【实验】：通过回顾岩手县中风登记数据确认中风发生情况，定义功能障碍为新获得长期护理保险认证的情况，将参与者分为三组：无中风和无功能障碍组（G1），中风后无功能障碍组（G2，其中缺血性中风177例，出血性中风55例），中风后功能障碍组（G3，其中缺血性中风346例，出血性中风170例），最终得出女性在出血性中风后功能障碍组中的比值比显著高于缺血性中风后功能障碍组。