Interaction of sex and diabetes on outcome after ischemic stroke
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- dc.contributor.author Soriano Reixach, Maria Montserrat
- dc.contributor.author Vivanco Hidalgo, Rosa María
- dc.contributor.author Ois Santiago, Angel Javier
- dc.contributor.author Rodríguez-Campello, Ana
- dc.contributor.author Roquer, Jaume
- dc.date.accessioned 2019-04-29T07:55:28Z
- dc.date.available 2019-04-29T07:55:28Z
- dc.date.issued 2018
- dc.description.abstract BACKGROUND: The relationship between ischemic stroke (IS), diabetes mellitus (DM), and sex is intriguing. The aim of this study was to assess the effect modification of sex in the association between DM and short- and long-term disability and mortality in first-ever IS patients. METHODS: In a retrospective, observational, hospital-based study of a prospective series including first-ever IS patients from January 2006 until July 2011, differences in 3-month and 5-year mortality, and disability between diabetic and non-diabetic patients [modified Rankin Scale (mRS) from 3 to 5] were analyzed by sex. RESULTS: In total, 933 patients (36.3% with DM, 50.5% women) were included. Overall 3-month and 5-year mortality were 150 (16.1%) and 407 (44.1%), respectively. Adjusted for age, previous mRS, and stroke severity, patients with DM had significantly higher 3-month disability [hazard ratio (HR): 1.49 (95% confidence interval (CI): 1.39-1.70), p < 0.0001], 5-year disability [HR: 1.41 (95% CI: 1.07-1.86), p = 0.015], and 5-year mortality [HR: 1.48 (95% CI: 1.20-1.81), p < 0.0001], compared with the non-DM group. Compared with non-DM women, women with diabetes had worse 3-month disability [HR: 1.81 (95% CI: 1.33-2.46), p < 0.0001] and 5-year mortality [HR: 1.72 (95% CI: 1.30-2.20), p < 0.0001], and a trend for 5-year disability [HR: 1.40 (95% CI: 0.99-2.09), p = 0.057]. In men, DM had an effect on 3-month disability [HR: 1.45 (95% CI: 1.07-1.96), p = 0.018], a trend for 5-year disability [HR: 1.43 (95% CI: 0.94-2.19), p = 0.096], but no clear effect on 5-year mortality [HR: 1.22 (95% CI: 0.91-1.65), p = 0.186]. CONCLUSION: Sex has a modifier effect on mortality in first-ever IS diabetic patients. Long-term mortality is increased in diabetic women compared with non-diabetic women, a difference not observed in men.
- dc.format.mimetype application/pdf
- dc.identifier.citation Soriano-Reixach MM, Vivanco-Hidalgo RM, Ois A, Rodríguez-Campello A, Roquer J. Interaction of sex and diabetes on outcome after ischemic stroke. Front Neurol. 2018 Apr 13;9:250. DOI: 10.3389/fneur.2018.00250
- dc.identifier.doi http://dx.doi.org/10.3389/fneur.2018.00250
- dc.identifier.issn 1664-2295
- dc.identifier.uri http://hdl.handle.net/10230/37143
- dc.language.iso eng
- dc.publisher Frontiers
- dc.relation.ispartof Frontiers in Neurology. 2018 Apr 13;9:250
- dc.rights © 2018 Soriano-Reixach, Vivanco-Hidalgo, Ois, Rodríguez-Campello and Roquer. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). https://creativecommons.org/licenses/by/4.0/. The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
- dc.rights.accessRights info:eu-repo/semantics/openAccess
- dc.rights.uri https://creativecommons.org/licenses/by/4.0/
- dc.subject.keyword Diabetes
- dc.subject.keyword Ischemic stroke
- dc.subject.keyword Mortality
- dc.subject.keyword Outcome
- dc.subject.keyword Sex differences
- dc.subject.other Diabetis
- dc.subject.other Isquèmia
- dc.title Interaction of sex and diabetes on outcome after ischemic stroke
- dc.type info:eu-repo/semantics/article
- dc.type.version info:eu-repo/semantics/publishedVersion