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The female stroke survival advantage: relation to age.

https://arctichealth.org/en/permalink/ahliterature91306
Source
Neuroepidemiology. 2009;32(1):47-52
Publication Type
Article
Date
2009
Author
Olsen Tom Skyhøj
Dehlendorff Christian
Andersen Klaus Kaae
Author Affiliation
Stroke Unit, Hvidovre University Hospital, Hvidovre, Denmark. Tom.Skyhoej.Olsen@hvh.regionh.dk
Source
Neuroepidemiology. 2009;32(1):47-52
Date
2009
Language
English
Publication Type
Article
Abstract
BACKGROUND: Age-related hormonal factors are thought to be related to the gender gap in longevity. Testing the hypothesis that survival is best in young premenopausal women we studied the effect of age on 1-week mortality in stroke patients. METHODS: A registry was started in 2001 with the aim of registering all hospitalized patients in Denmark. The patients' risk factors, stroke severity and CT scan were evaluated. A total of 25,607 patients (63%) gave complete information on all risk factors and were used in the analysis. Independent predictors of survival were identified by means of multiple logistic regression. RESULTS: The probability of death within 1 week adjusted for stroke severity, stroke type and risk factors was highly age-dependent in both men and women. Up to the age of 50 years, the 1-week female/male mortality rates paralleled being slightly (15%) but insignificantly better in women. While mortality increased almost linearly in women over the entire age range, it increased steeply in men from the age of 50 and at the age of 80 years survival was 80% better in women. CONCLUSION: The female stroke survival advantage applies to all ages. It increases with age due to a steeply increase of mortality in middle-aged and elderly men.
PubMed ID
19001796 View in PubMed
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Hemorrhagic and ischemic strokes compared: stroke severity, mortality, and risk factors.

https://arctichealth.org/en/permalink/ahliterature89360
Source
Stroke. 2009 Jun;40(6):2068-72
Publication Type
Article
Date
Jun-2009
Author
Andersen Klaus Kaae
Olsen Tom Skyhøj
Dehlendorff Christian
Kammersgaard Lars Peter
Author Affiliation
Informatics and Mathematical Modelling, Section for Statistics, Technical University of Denmark, Lyngby, Denmark.
Source
Stroke. 2009 Jun;40(6):2068-72
Date
Jun-2009
Language
English
Publication Type
Article
Keywords
Aged
Brain Ischemia - complications - mortality - pathology
Cerebral Hemorrhage - complications - mortality - pathology
Denmark - epidemiology
Female
Humans
Male
Regression Analysis
Risk factors
Sex Factors
Smoking - epidemiology
Stroke - etiology - mortality - pathology
Survival
Abstract
BACKGROUND AND PURPOSE: Stroke patients with hemorrhagic (HS) and ischemic strokes were compared with regard to stroke severity, mortality, and cardiovascular risk factors. METHODS: A registry started in 2001, with the aim of registering all hospitalized stroke patients in Denmark, now holds information for 39,484 patients. The patients underwent an evaluation including stroke severity (Scandinavian Stroke Scale), CT, and cardiovascular risk factors. They were followed-up from admission until death or censoring in 2007. Independent predictors of death were identified by means of a survival model based on 25,123 individuals with a complete data set. RESULTS: Of the patients 3993 (10.1%) had HS. Stroke severity was almost linearly related to the probability of having HS (2% in patients with the mildest stroke and 30% in those with the most severe strokes). Factors favoring ischemic strokes vs HS were diabetes, atrial fibrillation, previous myocardial infarction, previous stroke, and intermittent arterial claudication. Smoking and alcohol consumption favored HS, whereas age, sex, and hypertension did not herald stroke type. Compared with ischemic strokes, HS was associated with an overall higher mortality risk (HR, 1.564; 95% CI, 1.441-1.696). The increased risk was, however, time-dependent; initially, risk was 4-fold, after 1 week it was 2.5-fold, and after 3 weeks it was 1.5-fold. After 3 months stroke type did not correlate to mortality. CONCLUSIONS: Strokes are generally more severe in patients with HS. Within the first 3 months after stroke, HS is associated with a considerable increase of mortality, which is specifically associated with the hemorrhagic nature of the lesion.
PubMed ID
19359645 View in PubMed
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Prevalence of lower urinary tract symptoms (LUTS) in stroke patients: a cross-sectional, clinical survey.

https://arctichealth.org/en/permalink/ahliterature92996
Source
Neurourol Urodyn. 2008;27(8):763-71
Publication Type
Article
Date
2008
Author
Tibaek Sigrid
Gard Gunvor
Klarskov Peter
Iversen Helle K
Dehlendorff Christian
Jensen Rigmor
Author Affiliation
Department of Health Sciences, Division of Physiotherapy, Lund University, Lund, Sweden. sigrid@tibaek.dk
Source
Neurourol Urodyn. 2008;27(8):763-71
Date
2008
Language
English
Publication Type
Article
Keywords
Activities of Daily Living
Adult
Aged
Aged, 80 and over
Analgesics - adverse effects
Cost of Illness
Cross-Sectional Studies
Denmark - epidemiology
Female
Health Surveys
Humans
Male
Middle Aged
Nocturia - epidemiology - etiology
Paresis - complications - epidemiology
Prevalence
Quality of Life
Questionnaires
Risk factors
Severity of Illness Index
Stroke - complications - epidemiology
Urinary Incontinence - epidemiology - etiology
Abstract
AIMS: The aims of this study were primarily to investigate the prevalence, severity and impact on daily life of Lower Urinary Tract Symptoms (LUTS) in a clinical sample of stroke patients and secondly to identify factors associated with LUTS. MATERIALS AND METHODS: This was a cross-sectional, hospital based survey whereby stroke patients were invited by letter to complete The Danish Prostatic Symptom Score (DAN-PSS-1) questionnaire at least 1 month following their stroke. Subjects were asked to report the frequency and severity of their symptoms (symptom score) and the impact of each symptom on their daily life (bother score) over the previous fortnight. Of 519 stroke patients invited, 482 subjects were eligible. RESULTS: The response rate was 84%. The period prevalence of at least one symptom was 94%; the most frequent symptom was nocturia (76%) followed by urgency (70%) and daytime frequency (59%). The most severe symptom was urgency followed by nocturia and daytime frequency. Among respondents who had at least one symptom, the prevalence of bother was 78%. Likewise the most frequent bothersome symptom was nocturia (53%), followed by urgency (48%) and daytime frequency (40%). Paresis in legs, symptoms of urinary incontinence on admission, and use of analgesics were significantly associated with severity, whereas the prevalence and bother of LUTS could not be associated with other patient characteristics. CONCLUSION: LUTS are highly prevalent in stroke patients and have a major impact on daily life.
PubMed ID
18551565 View in PubMed
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Sex-related time-dependent variations in post-stroke survival--evidence of a female stroke survival advantage.

https://arctichealth.org/en/permalink/ahliterature87261
Source
Neuroepidemiology. 2007;29(3-4):218-25
Publication Type
Article
Date
2007
Author
Olsen Tom Skyhøj
Dehlendorff Christian
Andersen Klaus Kaae
Author Affiliation
Stroke Unit, Hvidovre University Hospital, Hvidovre, Denmark. Tom.Skyhoej.Olsen@hvh.regionh.dk
Source
Neuroepidemiology. 2007;29(3-4):218-25
Date
2007
Language
English
Publication Type
Article
Keywords
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
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.
PubMed ID
18075278 View in PubMed
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