To analyze incidence, use of therapeutic procedures, use of oral anticoagulants (OACs) and antiplatelet agents prior to hospitalization, and in-hospital outcomes among patients who were hospitalized with hemorrhagic stroke (HS) according to the presence of type 2 diabetes mellitus (T2DM) in Spain (2016–2018) and to assess the role of sex differences among those with T2DM. Using the Spanish National Hospital Discharge Database we estimated the incidence of HS hospitalizations in men and women aged ≥ 35 years with and without T2DM. Propensity score matching (PSM) was used to compare population subgroups according to sex and the presence of T2DM. HS was coded in 31,425 men and 24,975 women, of whom 11,915 (21.12%) had T2DM. The adjusted incidence of HS was significantly higher in patients with T2DM (both sexes) than in non-T2DM individuals (IRR 1.15; 95% CI 1.12–1.17). The incidence of HS was higher in men with T2DM than in T2DM women (adjusted IRR 1.60; 95% CI 1.57–1.63). After PSM, men and women with T2DM have significantly less frequently received decompressive craniectomy than those without T2DM. In-hospital mortality (IHM) was higher among T2DM women than matched non-T2DM women (32.89% vs 30.83%; p = 0.037), with no differences among men. Decompressive craniectomy was significantly more common in men than in matched women with T2DM (5.81% vs. 3.33%; p < 0.001). IHM was higher among T2DM women than T2DM men (32.89% vs. 28.28%; p < 0.001). After adjusting for confounders with multivariable logistic regression, women with T2DM had a 18% higher mortality risk than T2DM men (OR 1.18; 95% CI 1.07–1.29). Use of OACs and antiplatelet agents prior to hospitalization were associated to higher IHM in men and women with and without T2DM. T2DM is associated with a higher incidence of HS and with less frequent use of decompressive craniectomy in both sexes, but with higher IHM only among women. Sex differences were detected in T2DM patients who had experienced HS, with higher incidence rates, more frequent decompressive craniectomy, and lower IHM in men than in women.

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2 型糖尿病患者出血性卒中发生率和结局的性别相关差异：使用 2016-18 年西班牙国家医院出院数据库的倾向评分匹配分析

根据 2 型糖尿病 (T2DM) 的存在，分析出血性卒中 (HS) 住院患者的发病率、治疗程序的使用、住院前口服抗凝剂 (OAC) 和抗血小板药物的使用情况以及住院结果) 在西班牙 (2016-2018) 并评估性别差异在 T2DM 患者中的作用。使用西班牙国家医院出院数据库，我们估计了 35 岁以上男性和女性患有和不患有 T2DM 的 HS 住院发生率。倾向评分匹配 (PSM) 用于根据性别和 T2DM 的存在来比较人口亚组。HS 在 31,425 名男性和 24,975 名女性中编码，其中 11,915 (21.12%) 名患有 T2DM。T2DM 患者（男女）的 HS 调整后发病率显着高于非 T2DM 患者（IRR 1.15；95% 置信区间 1.12–1.17）。T2DM 男性的 HS 发生率高于 T2DM 女性（调整后的 IRR 1.60；95% CI 1.57–1.63）。PSM 后，T2DM 男性和女性接受去骨瓣减压术的频率明显低于非 T2DM 患者。T2DM 女性的住院死亡率 (IHM) 高于匹配的非 T2DM 女性（32.89% 对 30.83%；p = 0.037），男性之间没有差异。去骨瓣减压术在男性中比在匹配的 T2DM 女性中更常见（5.81% 对 3.33%；p < 0.001）。T2DM 女性的 IHM 高于 T2DM 男性（32.89% 对 28.28%；p < 0.001）。在用多变量逻辑回归调整混杂因素后，T2DM 女性的死亡风险比 T2DM 男性高 18%（OR 1.18；95% CI 1.07–1.29）。住院前使用 OAC 和抗血小板药物与患有和不患有 T2DM 的男性和女性的更高 IHM 相关。T2DM 与较高的 HS 发病率和两性中较少使用去骨瓣减压术有关，但仅在女性中 IHM 较高。在经历过 HS 的 T2DM 患者中检测到性别差异，男性的发病率更高，去骨瓣减压术的频率更高，IHM 低于女性。