Sex differences in treatment and outcome after stroke: pooled analysis including 19,000 participants

Objective: To explore the sex differences in outcomes and management after stroke using a large sample with high-quality international trial data.
Methods: Individual participant data were obtained from five acute stroke randomized controlled trials. Data were obtained on demographics, medication use, in-hospital treatment and functional outcome. Study-specific crude and adjusted models were used to estimate sex differences in outcomes and management, and then pooled using random-effects meta-analysis.
Results: There were 19,652 participants of whom 7721 (40%) were women. After multivariable adjustments, women with ischemic stroke had higher survival at 3 to 6 months (odds ratio [OR] 0.82; 95% confidence interval [CI] 0.70-0.97), higher likelihood of disability (OR 1.20; 95% CI 1.06-1.36) and worse quality of life (weighted mean difference -0.07, 95% CI -0.09—0.04). For management, women were more likely admitted to an acute stroke unit (OR 1.17, 95% CI 1.01-1.34), but less likely ...