Background: Sex differences may determine presentation, utility of treatment, rehabilitation, and occurrences of major adverse cardiovascular events (MACEs) in acute stroke (AS). Objective:The purpose of the study was to evaluate the short-term prognosis and long-term outcomes in MACEs in Qatari nationals admitted with AS. Methods: All AS patients admitted between January 2014 and February 2019 were included. We evaluated the preadmission modified Rankin scale (mRS) score, etiology and severity of symptoms, complications, and functional recovery at discharge and 90 days. MACEs were recorded for 5 years. Results: There were 891 admissions for AS (mean age 64.0 ± 14.2 years) (male, n = 519 [mean age ± SD 62.9 ± 14.1 years]; female, n = 372 [mean age ± SD 65.6 ± 14.2 years] p = 0.005). There were no differences in the preadmission mRS and severity of symptoms as measured on National Institute of Stroke Scale. At discharge, the outcome was better (mRS 0–2) in men (57.8 vs. 46.0%), p = 0.0001. This difference persisted at the 90-day follow-up (mRS 0–2, male 69.4% vs. female 53.2%, p = 0.0001). At the 90-day follow-up, more women died (total deaths 70; women 38 [10.2%] versus men 32 [6.2%], p = 0.03). MACEs occurred in 25.6% (133/519) males and 30.9% (115/372) females over the 5-year follow-up period (odds ratio 0.77, 95% confidence interval 0.57–1.0, p = 0.83). Conclusions: Female patients have a poor short-term outcome following an AS when corrected for age and comorbidities. While our study cannot explain the reasons for the discrepancies, higher poststroke depression and social isolation in women may be important contributory factors, and requires further studies are required to confirm these findings.

中文翻译：

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卡塔尔急性卒中患者短期和长期预后的性别差异

背景：性别差异可能决定急性卒中 (AS) 的表现、治疗效用、康复和主要不良心血管事件 (MACE) 的发生。目的：该研究的目的是评估因 AS 入院的卡塔尔国民 MACE 的短期预后和长期结果。方法：纳入2014年1月至2019年2月期间收治的所有AS患者。我们评估了入院前改良 Rankin 量表 (mRS) 评分、症状的病因和严重程度、并发症以及出院和 90 天的功能恢复。MACE 记录了 5 年。结果：有 891 人入院 AS（平均年龄 64.0 ± 14.2 岁）（男性，n = 519 [平均年龄 ± SD 62.9 ± 14.1 岁]；女性，n = 372 [平均年龄 ± SD 65.6 ± 14.2 岁] p = 0.005）。根据国家卒中量表测量，入院前 mRS 和症状严重程度没有差异。出院时，男性的结果更好（mRS 0-2）（57.8% vs. 46.0%），p = 0.0001。这种差异在 90 天的随访中持续存在（mRS 0-2，男性 69.4% 与女性 53.2%，p = 0.0001）。在 90 天的随访中，更多女性死亡（总死亡人数为 70；女性 38 [10.2%] 对男性 32 [6.2%]，p = 0.03）。在 5 年随访期间，MACE 发生在 25.6% (133/519) 男性和 30.9% (115/372) 女性中（优势比 0.77，95% 置信区间 0.57-1.0，p = 0.83）。结论：在校正年龄和合并症后，女性患者在 AS 后的短期预后较差。虽然我们的研究无法解释差异的原因，