INTRODUCTION The mortality and morbidity rates of stroke in men and women have been reported differently and its effective factors have been discussed. The purpose of this study was to investigate sex differences in 28-day mortality of ischemic stroke and its associated factors. MATERIALS AND METHODS This is a prospective cohort study conducted from June 2018 to September 2019 in patients with ischemic stroke referred to Firoozgar, Shariati and Sina hospitals in Tehran. Demographic data, risk factors, disease history, drug use, severity of stroke, and patient functional status were recorded in the hospital. The patients' functional status and severity of stroke were measured using the Modified Ranking Scale (MRS) and the National Institutes of Health Stroke Scale (NIHSS). After 28 days, the patients' survival status was monitored. Logistic regression was used to analyze the data. RESULTS In this study, 703 patients were enrolled; of them, 260 (37.00%) were female and 443 (63.00%) were male. After 28 days, 21 female cases (8.17%) and 26 male (6.08%) ones died (P = 0.299). Functional status (OR = 4.65; 95%CI: 2.09 to 10.38), diastolic blood pressure (OR = 0.91; 95%CI: 0.85 to 0.96), warfarin use (OR = 0.15; 95%CI: 0.04 to 0.55), and hemoglobin (OR = 1.17; 95%CI: 1.02 to 1.35) were associated with 28-day mortality. Poor functional status in men had a greater association with 28-day mortality than women (OR 4.65 vs. 1.64). High diastolic blood pressure had a negative association with the 28-day mortality of cases and this association is more in women than in men (OR 0.88 vs. 0.91). High hemoglobin is a risk factor in men and a protective factor in 28-day mortality in women (OR 1.73 vs. 0.73). Smoking also had a greater association with 28-day mortality in women than men (OR 2.67 vs. 1.2). DISCUSSION Twenty eight-day mortality was more in women than in men, but this difference was not significant. Women were older, had more severe stroke and poorer functional status than men. Variables including functional status, diastolic blood pressure, hemoglobin level, and smoking had interaction with sex, and their association with 28-day mortality rate was different between men and women. Sex differences should be considered, so that we can better manage stroke patients.

中文翻译：

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伊朗缺血性卒中28天死亡率中的性别差异及其相关因素：一项前瞻性队列研究。

引言关于男性和女性中风的死亡率和发病率的报道不同，并且已经讨论了其有效因素。这项研究的目的是调查缺血性中风的28天死亡率及其相关因素的性别差异。材料与方法这是一项自2018年6月至2019年9月在缺血性中风患者中进行的前瞻性队列研究，涉及德黑兰的Firoozgar，Shariati和Sina医院。医院记录了人口统计学数据，危险因素，疾病史，药物使用，中风的严重程度和患者的功能状态。使用改良等级量表（MRS）和美国国立卫生研究院卒中量表（NIHSS）测量患者的功能状态和中风严重程度。28天后，监测患者的生存状况。使用逻辑回归分析数据。结果本研究共纳入703例患者。其中，女性为260名（37.00％），男性为443名（63.00％）。28天后，有21例女性（8.17％）和26例男性（6.08％）死亡（P = 0.299）。功能状态（OR = 4.65; 95％CI：2.09至10.38），舒张压（OR = 0.91; 95％CI：0.85至0.96），使用华法林（OR = 0.15; 95％CI：0.04至0.55）和血红蛋白（OR = 1.17； 95％CI：1.02至1.35）与28天死亡率相关。男性功能状况较差与28天死亡率的关联性高于女性（OR 4.65与1.64）。舒张压高与28天病死率呈负相关，女性比男性高（OR 0.88 vs. 0.91）。高血红蛋白是男性的危险因素，是女性28天死亡率的保护因素（OR 1.73对0.73）。吸烟与女性28天死亡率的相关性也比男性高（OR 2.67 vs. 1.2）。讨论妇女的二十八天死亡率比男子高，但这种差异并不显着。女性比男性年龄更大，中风更严重，功能状况更差。包括功能状态，舒张压，血红蛋白水平和吸烟在内的变量与性别有相互作用，男女与28天死亡率的相关性也有所不同。应该考虑性别差异，以便我们可以更好地管理中风患者。讨论妇女的二十八天死亡率比男子高，但这种差异并不显着。女性比男性年龄更大，中风更严重，功能状况更差。包括功能状态，舒张压，血红蛋白水平和吸烟在内的变量与性别有相互作用，男女与28天死亡率的相关性也有所不同。应该考虑性别差异，以便我们可以更好地管理中风患者。讨论妇女的二十八天死亡率比男子高，但这种差异并不显着。女性比男性年龄更大，中风更严重，功能状况更差。包括功能状态，舒张压，血红蛋白水平和吸烟在内的变量与性别具有相互作用，男女之间与28天死亡率的关联也不同。应该考虑性别差异，以便我们可以更好地管理中风患者。