Background: Only controversial data is available on theoutcomes of LVO patients regarding sex differences. We aimed to clarify the potential effect of sex on the long term, 5-year mortality following endovascular stroke therapy (EST).
Methods: Consecutive patients treated with EST for LVO between the 1st of January 2015 and the 31st of December 2019 were included in our prospective registry from a single high-volume center. Baseline clinical characteristics and long-term mortality data were compared between women and men. We conducted multivariate cox regression analysis to identify potential independent predictors of mortality, afterwards we applied propensity score matching on the variables of the multivariate model to address confounding. Mortality follow-up data was acquired from National Health Insurance database. The mortality follow-up rate was very high, over 98%.
Results: The clinical and follow up data of 1246 MT patients were analyzed, 596 (47,8%) were women and 650 (52.2 %) patients were men in our registry. We performed a multivariate cox regression analysis to identify potential independent predictors of mortality in LVO patients. We found that female sex is an independent predictor of decreasing mortality (HR: 0.76, p=0.001). Age (HR: 1.72, p<0.001), HT (HR: 1.45 p=0.008), ischaemic heart disease (HR: 1.27 p=0.013), and diabetes mellitus (DM) (HR: 1.34 p=0.02) were shown to increase mortality significantly. Propensity score matching to the mortality predictors of LVO patients showed, that after adjusting for potential confounders, female sex was shown to be still an independent mortality decreasing factor in those with cerebral LVO (p=0.017).
Conclusion: Female sex is associated with decreased long-term overall mortality in patients undergoing.
MT for acute ischemic stroke caused by LVO. Our results underline the significance of further evaluation of underlying causes of the role of sex in these ischaemic stroke patients to improve prognosis and the use of scoring systems.