Sex is not an independent predictor of 90-day outcomes after mechanical thrombectomy in Chinese patients with acute ischemic stroke: a prospective cohort study

TL;DR

This study found that sex does not independently affect 90-day outcomes in Chinese patients who underwent mechanical thrombectomy for stroke.

Contribution

The study shows that sex is not an independent predictor of recovery after stroke treatment in Chinese patients.

Findings

Female patients were older and had higher glucose levels and atrial fibrillation rates.

Male patients had higher smoking rates.

After adjusting for factors, sex did not predict favorable 90-day outcomes.

Abstract

To explore the impact of sex difference in the 90-day favourable outcome after mechanical thrombectomy(MT) with acute ischaemic stroke(AIS).

We consecutively enrolled AIS patients treated with MT from the First Affiliated Hospital of Chengdu Medical College and Nanjing First Hospital between June 2015 to June 2022. According to the inclusion and exclusion criteria. Patients were divided into two groups by sex, and detailed demographic, laboratory examination, imaging examination and clinical data were collected. The primary outcome (favourable 90-day outcomes, mRS 0-2) was prospectively followed up. Univariate and multivariate logistic regressions were performed with SPSS 26.0.

Among 334 patients analyzed (198 male, 136 female), females were significantly older (median age: 76.0 vs. 68.5 years, P < 0.001), had higher admission glucose levels (7.3 vs. 6.5 mmol/L, P = 0.031), and higher prevalence of atrial fibrillation (47.1% vs. 26.3%, P = 0.001). Male patients had higher smoking rates (59.6% vs. 5.1%, P < 0.001). In univariate analysis, female sex was associated with lower odds of favorable outcome (OR 0.520, 95% CI 0.323–0.836, P = 0.007). However, after adjustment for age, baseline NIHSS, 24-hour NIHSS, mTICI 2b–3, hemorrhagic transformation, smoking, and fasting glucose, sex was not an independent predictor of 90-day favorable outcome (aOR 0.97, 95% CI 0.451–2.081, P = 0.939).

Sex and 90-day favorable outcomes in Chinese patients with AIS undergoing MT are not independently associated.

Figures