RT Journal Article
SR Electronic
T1 Biological Sex Differences in Risk Factors and Outcomes Among Hospitalized Adults With Stroke in Lusaka, Zambia
JF Neurology
JO Neurology
FD Lippincott Williams & Wilkins
SP 10.1212/WNL.0000000000201696
DO 10.1212/WNL.0000000000201696
A1 Aparna Nutakki
A1 Mashina Chomba
A1 Lorraine Chishimba Chishimba
A1 Stanley Zimba
A1 Rebecca F. Gottesman
A1 Mona N. Bahouth
A1 Deanna R. Saylor
YR 2022
UL http://n.neurology.org/content/early/2022/12/19/WNL.0000000000201696.abstract
AB Background: We investigated sex differences in clinical characteristics and outcomes among hospitalized adults with stroke in Zambia.Methods: We retrospectively collected information for 324 consecutively hospitalized adults with stroke on the neurology service at the University Teaching Hospital in Lusaka, Zambia between October 2018 - March 2019. Stroke characteristics were then compared by biological sex.Results: Females constituted 62% (n=200) of the cohort, were older (61+19 vs 57+16 years, p=0.06), had fewer hemorrhagic stroke than males (22% vs 37%, p=0.001), and higher rates of hypertension (84% vs 74%, p=0.04), diabetes (19% vs 13%, p=0.04), heart disease (38% vs. 27%, p=0.04) and prior history of stroke (26% vs. 14%, p=0.01). Males had higher rates of alcohol (33% vs. 4%, p<0.001) and tobacco (19% vs. 2%, p<0.001) use. Females were less likely to have neuroimaging completed during their hospitalization (82% vs 94%, p=0.002) and had higher 90-day post-discharge mortality was (28% vs 10%, p=0.002) independent of age and stroke subtype (OR 2.48, 95% CI 1.1-5.58, p=0.03).Discussion: Females in this Zambian stroke cohort had a higher prevalence of vascular risk factors but were less likely to have neuroimaging completed. Post-discharge mortality was markedly higher among females even after adjusting for age and stroke subtype. Our data highlight the need for future studies of social and socioeconomic factors that may influence stroke-related outcomes.