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Sex differences in the integrated stroke management in a rural healthcare area in Asturias

T. López-Martínez, J. Bernardo-Cofiño, E. Prieto-García, M. Feito-Álvarez, R. de Dios-Del Valle, S. Calleja-Puerta [REV NEUROL 2016;63:151-159] PMID: 27439484 DOI: https://doi.org/10.33588/rn.6304.2016074

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Volumen 63 | Number 04 | Nº of views of the article 5.064 | Nº of PDF downloads 230 | Article publication date 16/08/2016

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ABSTRACT

INTRODUCTION Sex differences and the (rural or urban) nature of populations largely determine the integrated management of time-dependent pathologies such as strokes, which is the main cause of female hospitalisation and mortality in our setting.

AIM To determine whether any differential characteristics can be observed between male and female stroke patients in a rural healthcare area in the Principality of Asturias.

PATIENTS AND METHODS A descriptive retrospective study was conducted at the Jarrio Hospital. Different variables were reviewed using the computerised medical records of patients who suffered a stroke in 2013.

RESULTS Altogether 126 patients were discharged, 53.2% among females, who suffered the disease with a five-year delay (p < 0.008) with respect to males. These latter smoked more and also drank harmful amounts of alcohol (p < 0.000). The pre-hospital delay did not yield any significant sex differences. Language disorder was the main symptom in the female group (p < 0.008), who scored higher on the National Institute of Health Stroke Scale (p < 0.046). Complementary studies, such as Holter monitoring (p < 0.04) and ultrasound scanning of the supra-aortic trunks (p < 0.02), are conducted less often in females, who mainly received conservative treatment with greater parenteral hydration (p < 0.017) and rest. The female group suffered more complications, disability at discharge (p < 0.001) and at three months (p < 0.004), and recorded higher percentages of subsequent institutionalisation (p < 0.005).

CONCLUSIONS There are demographic sex differences in the cerebrovascular risk profile, clinical presentation, hospital management and comorbidity of stroke in this rural population, which suggest that there are areas where there is room for improvement. KeywordsDisability Hospital Institutionalisation Rural population Sex differences Stroke CategoriesPatología vascular

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Sex differences in the integrated stroke management in a rural healthcare area in Asturias