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Abstract
Objective We investigated sex differences in clinical characteristics and outcomes among hospitalized adults with stroke in Zambia.
Methods We retrospectively collected information for 324 consecutively hospitalized adults with stroke on the neurology service at the University Teaching Hospital in Lusaka, Zambia, between October 2018 and March 2019. Stroke characteristics were then compared by biological sex.
Results Female participants constituted 62% (n = 200) of the cohort, were older (61 ± 19 vs 57 ± 16 years, p = 0.06), had fewer hemorrhagic stroke than male participants (22% vs 37%, p = 0.001), and had higher rates of hypertension (84% vs 74%, p = 0.04), diabetes (19% vs 13%, p = 0.04), heart disease (38% vs 27%, p = 0.04), and history of stroke (26% vs 14%, p = 0.01). Male participants had higher rates of alcohol (33% vs 4%, p < 0.001) and tobacco (19% vs 2%, p < 0.001) use. Female participants were less likely to have neuroimaging completed during their hospitalization (82% vs 94%, p = 0.002) and had higher 90 days postdischarge mortality (28% vs 10%, p = 0.002) independent of age and stroke subtype (OR 2.48, 95% CI 1.1–5.58, p = 0.03).
Discussion Female participants in this Zambian stroke cohort had a higher prevalence of vascular risk factors but were less likely to have neuroimaging completed. Postdischarge mortality was markedly higher among female participants even after adjusting for age and stroke subtype. Our data highlight the need for future studies of social and socioeconomic factors that may influence stroke-related outcomes.
Footnotes
Submitted and externally peer reviewed. The handling editor was Editor-in-Chief José Merino, MD, MPhil, FAAN.
Go to Neurology.org/N for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.
- Received May 2, 2022.
- Accepted in final form November 1, 2022.
- Written work prepared by employees of the Federal Government as part of their official duties is, under the U.S. Copyright Act, a “work of the United States Government” for which copyright protection under Title 17 of the United States Code is not available. As such, copyright does not extend to the contributions of employees of the Federal Government.
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