Sex differences on risk factors, clinical characteristics and early death of stroke
	    		
		   		
	    	
    	
    	
   		
        
        	
        		- VernacularTitle:Тархины харвалтын эрсдэлт хүчин зүйлс, эмнэлзүйн байдал, эрт үеийн нас  баралтын хүйсийн ялгааг судалсан дүн
 
        	
        	
        	
        		- Author:
	        		
		        		
		        		
			        		Khandsuren B
			        		
			        		
			        		
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			        		Punsaldulam B
			        		
			        		
			        		
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			        		Bolormaa D
			        		
			        		
			        		
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			        		Uuriinmuya M
			        		
			        		
			        		
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			        		Mandakhnar M
			        		
			        		
			        		
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			        		Oyungerel B
			        		
			        		
			        		
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			        		Sarantsetseg T
			        		
			        		
			        		
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			        		Tuguldur E
			        		
			        		
			        		
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			        		Erdenechimeg Ya
			        		
			        		
			        		
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			        		Baasanjav D
			        		
			        		
			        		
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			        		Chimeglham B
			        		
			        		
			        		
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			        		Author Information
			        		
		        		
		        		
			        		
			        		
			        			1. Institute of Medical Sciences, MNUMS
			        		
		        		
	        		
        		 
        	
        	
        	
        		- Publication Type:Journal Article
 
        	
        	
        		- Keywords:
        			
	        			
	        				
	        				
			        		
				        		sex difference;
			        		
			        		
			        		
				        		stroke registry;
			        		
			        		
			        		
				        		risk factors;
			        		
			        		
			        		
				        		death;
			        		
			        		
			        		
				        		Mongolia
			        		
			        		
	        			
        			
        		
 
        	
            
            
            	- From:Mongolian Medical Sciences
	            		
	            		 2021;197(3):40-47
	            	
            	
 
            
            
            	- CountryMongolia
 
            
            
            	- Language:Mongolian
 
            
            
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		        	Abstract:
			       	
			       		
				        
				        	Background:Stroke is one of the leading causes of mortality and disability worldwide. Understanding 
sex differences in risk factors, clinical characteristics and death after stroke might provide valuable 
evidence for prevention and management of stroke. 
				        	
				        
				        	Aim:We aimed to describe sex differences in risk factors, clinical characteristics and death after 
intracerebral hemorrhage (ICH) and ischemic stroke (IS) using hospital-based registry in 6 districts 
of Ulaanbaatar, Mongolia. 
				        	
				        
				        	Materials and methods:We used hospital-based stroke registry in Ulaanbaatar Mongolia. From 
2019 to 2020, total of 974 patients with acute ICH and 1612 patients with acute IS were enrolled in 
this study. The severity of stroke was measured by National Institutes of Health Stroke Scale (NIHSS) 
and Glasgow Coma Scale (GCS). Risk factors for stroke were defined as patient’s history and their 
medical record. Death after stroke was registered at 28 days and 90 days by follow-up study. A 
comparison of categorical and continuous variables was analyzed using chi-squared test, Student’s 
t-test and Mann Whitney U test. Univariable and multivariable logistic regression analyses were also 
performed.
				        	
				        
				        	Results:The mean age of ICH patients was 58.41±11.56. There was significant difference in age (59 
vs 57, p=0.009) between women and men. Men with ICH were more likely to drink alcohol (35.4% vs 
5.2%, p=0.000) and to smoke (37.0% vs 8.4%, p=0.000) and to have arterial hypertension (72.7% vs 
58.6%, p=0.000). However, there were no significant differences in other risk factors including atrial 
fibrillation, diabetes mellitus, prior stroke and other cardiac diseases. There were no sex differences 
in clinical characteristics including systole and diastole blood pressure, NIHSS scores and GCS. In 
our study, case fatality rate was 23.8% at 28 days and 1.9% at 90 days after ICH. By multivariable 
regression analyses, there were no significant association between sex and death at 28 days and at 
90 days (OR:0.74; 95% CI:0.52-1.06, OR: 0.80; 95% CI:0.29-2.21).
The mean age of IS patients was 61.07±12.88. The women were older (63 vs 59, p=0.000) than men. 
Men with IS also were more likely to be current smokers (37.6% vs 9.0%, p=0.000), current drinkers 
(33.2% vs 3.4%, p=0.000) and to have arterial hypertension (74.7% vs 65.9%, p=0.000). There were 
no significant differences in other risk factors. For IS patients, there also was no sex difference in 
clinical characteristics. Case fatality rate was 13.3% at 28 days and 1.1% at 90 days after IS. By 
multivariable regression analyses, there were no significant association between sex and death at 28 
days and at 90 days (OR:0.90; 95%CI: 0.64-1.26, OR:5.16; 95%CI: 0.99-23.9). 
				        	
				        
				        	Conclusion:Our study showed sex differences in some vascular factors of both stroke subtypes 
which emphasized that we need to implement stroke prevention targeting sex-specific risk factors. 
While clinical characteristics and early mortality of intracerebral hemorrhage and ischemic stroke 
were not differed by gender.
				        	
				        
				    
			     
	        
	        
	        	- Full text:2021-197(3)-40-47.pdf