Incidence and Outcomes of Hemorrhagic Stroke among Adults in Spain (2016–2018) According to Sex: A Retrospective, Cohort, Observational, Propensity Score Matched Study
(1) Background: We aim to analyze sex differences in the incidence, clinical characteristics and in-hospital outcomes of hemorrhagic stroke (HS) in Spain (2016–2018) using the National Hospital Discharge Database. (2) Methods: Retrospective, cohort, observational study. We estimated the incidence of...
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doaj-d1ec0be225b94a2ea69cb0934da10b302021-08-26T13:56:10ZengMDPI AGJournal of Clinical Medicine2077-03832021-08-01103753375310.3390/jcm10163753Incidence and Outcomes of Hemorrhagic Stroke among Adults in Spain (2016–2018) According to Sex: A Retrospective, Cohort, Observational, Propensity Score Matched StudyJose M. de Miguel-Yanes0Ana Lopez-de-Andres1Rodrigo Jimenez-Garcia2Valentin Hernandez-Barrera3Javier de Miguel-Diez4Manuel Méndez-Bailón5Napoleón Pérez-Farinós6Nuria Muñoz-Rivas7David Carabantes-Alarcon8Marta López-Herranz9Internal Medicine Department, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Universidad Complutense de Madrid, 28040 Madrid, SpainDepartment of Public Health & Maternal and Child Health, Faculty of Medicine, Universidad Complutense de Madrid, 28040 Madrid, SpainDepartment of Public Health & Maternal and Child Health, Faculty of Medicine, Universidad Complutense de Madrid, 28040 Madrid, SpainPreventive Medicine and Public Health Teaching and Research Unit, Health Sciences Faculty, Universidad Rey Juan Carlos, Alcorcón, 28922 Madrid, SpainRespiratory Department, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Universidad Complutense de Madrid, 28040 Madrid, SpainInternal Medicine Department, Hospital Universitario Clínico San Carlos, Universidad Complutense de Madrid, 28040 Madrid, SpainPublic Health and Psychiatry Department, Faculty of Medicine, Universidad de Málaga, 29010 Málaga, SpainInternal Medicine Department, Hospital Universitario Infanta Leonor, 28031 Madrid, SpainDepartment of Public Health & Maternal and Child Health, Faculty of Medicine, Universidad Complutense de Madrid, 28040 Madrid, SpainNursing Department, Faculty of Nursing, Physiotherapy and Podology, Universidad Complutense de Madrid, 28040 Madrid, Spain(1) Background: We aim to analyze sex differences in the incidence, clinical characteristics and in-hospital outcomes of hemorrhagic stroke (HS) in Spain (2016–2018) using the National Hospital Discharge Database. (2) Methods: Retrospective, cohort, observational study. We estimated the incidence of HS in men and women. We analyzed comorbidity, treatments, procedures, and hospital outcomes. We matched each woman with a man by age, type of HS and medical conditions using propensity score matching. (3) Results: HS was coded in 57,227 patients aged ≥18 years (44.3% women). Overall, men showed higher incidence rates (57.3/10<sup>5</sup> vs. 43.0/10<sup>5</sup>; <i>p</i> < 0.001; IRR = 1.60; 95% CI: 1.38–1.83). Women suffered more subarachnoid hemorrhages (25.2% vs. 14.6%), whereas men more often had intracerebral hemorrhages (55.7% vs. 54.1%). In-hospital mortality (IHM) was higher for intracerebral hemorrhage in both men and women. Women underwent decompressive craniectomy less often than men (5.0% vs. 6.2%; <i>p</i> < 0.001). After matching, IHM among women was higher (29.0% vs. 23.7%; <i>p</i> < 0.001). Increments in age, comorbidity and use of anticoagulants and antiplatelet agents prior to hospitalization were associated were higher IHM, and decompressive craniectomy was associated with lower IHM in both sexes. After multivariable adjustment, women had higher IHM (OR = 1.23; 95% CI: 1.18–1.28). (4) Conclusion: Men had higher incidence rates of HS than women. Women less often underwent decompressive craniectomy. IHM was higher among women admitted for HS than among men.https://www.mdpi.com/2077-0383/10/16/3753hemorrhagic strokesex differencesdecompressive craniectomyin-hospital mortality |
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language |
English |
format |
Article |
sources |
DOAJ |
author |
Jose M. de Miguel-Yanes Ana Lopez-de-Andres Rodrigo Jimenez-Garcia Valentin Hernandez-Barrera Javier de Miguel-Diez Manuel Méndez-Bailón Napoleón Pérez-Farinós Nuria Muñoz-Rivas David Carabantes-Alarcon Marta López-Herranz |
spellingShingle |
Jose M. de Miguel-Yanes Ana Lopez-de-Andres Rodrigo Jimenez-Garcia Valentin Hernandez-Barrera Javier de Miguel-Diez Manuel Méndez-Bailón Napoleón Pérez-Farinós Nuria Muñoz-Rivas David Carabantes-Alarcon Marta López-Herranz Incidence and Outcomes of Hemorrhagic Stroke among Adults in Spain (2016–2018) According to Sex: A Retrospective, Cohort, Observational, Propensity Score Matched Study Journal of Clinical Medicine hemorrhagic stroke sex differences decompressive craniectomy in-hospital mortality |
author_facet |
Jose M. de Miguel-Yanes Ana Lopez-de-Andres Rodrigo Jimenez-Garcia Valentin Hernandez-Barrera Javier de Miguel-Diez Manuel Méndez-Bailón Napoleón Pérez-Farinós Nuria Muñoz-Rivas David Carabantes-Alarcon Marta López-Herranz |
author_sort |
Jose M. de Miguel-Yanes |
title |
Incidence and Outcomes of Hemorrhagic Stroke among Adults in Spain (2016–2018) According to Sex: A Retrospective, Cohort, Observational, Propensity Score Matched Study |
title_short |
Incidence and Outcomes of Hemorrhagic Stroke among Adults in Spain (2016–2018) According to Sex: A Retrospective, Cohort, Observational, Propensity Score Matched Study |
title_full |
Incidence and Outcomes of Hemorrhagic Stroke among Adults in Spain (2016–2018) According to Sex: A Retrospective, Cohort, Observational, Propensity Score Matched Study |
title_fullStr |
Incidence and Outcomes of Hemorrhagic Stroke among Adults in Spain (2016–2018) According to Sex: A Retrospective, Cohort, Observational, Propensity Score Matched Study |
title_full_unstemmed |
Incidence and Outcomes of Hemorrhagic Stroke among Adults in Spain (2016–2018) According to Sex: A Retrospective, Cohort, Observational, Propensity Score Matched Study |
title_sort |
incidence and outcomes of hemorrhagic stroke among adults in spain (2016–2018) according to sex: a retrospective, cohort, observational, propensity score matched study |
publisher |
MDPI AG |
series |
Journal of Clinical Medicine |
issn |
2077-0383 |
publishDate |
2021-08-01 |
description |
(1) Background: We aim to analyze sex differences in the incidence, clinical characteristics and in-hospital outcomes of hemorrhagic stroke (HS) in Spain (2016–2018) using the National Hospital Discharge Database. (2) Methods: Retrospective, cohort, observational study. We estimated the incidence of HS in men and women. We analyzed comorbidity, treatments, procedures, and hospital outcomes. We matched each woman with a man by age, type of HS and medical conditions using propensity score matching. (3) Results: HS was coded in 57,227 patients aged ≥18 years (44.3% women). Overall, men showed higher incidence rates (57.3/10<sup>5</sup> vs. 43.0/10<sup>5</sup>; <i>p</i> < 0.001; IRR = 1.60; 95% CI: 1.38–1.83). Women suffered more subarachnoid hemorrhages (25.2% vs. 14.6%), whereas men more often had intracerebral hemorrhages (55.7% vs. 54.1%). In-hospital mortality (IHM) was higher for intracerebral hemorrhage in both men and women. Women underwent decompressive craniectomy less often than men (5.0% vs. 6.2%; <i>p</i> < 0.001). After matching, IHM among women was higher (29.0% vs. 23.7%; <i>p</i> < 0.001). Increments in age, comorbidity and use of anticoagulants and antiplatelet agents prior to hospitalization were associated were higher IHM, and decompressive craniectomy was associated with lower IHM in both sexes. After multivariable adjustment, women had higher IHM (OR = 1.23; 95% CI: 1.18–1.28). (4) Conclusion: Men had higher incidence rates of HS than women. Women less often underwent decompressive craniectomy. IHM was higher among women admitted for HS than among men. |
topic |
hemorrhagic stroke sex differences decompressive craniectomy in-hospital mortality |
url |
https://www.mdpi.com/2077-0383/10/16/3753 |
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