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(Stroke. 2006;37:2989.)
© 2006 American Heart Association, Inc.

Original Contributions

Is Sex a Prognostic Factor in Stroke Rehabilitation?

A Matched Comparison

Stefano Paolucci, MD; Maura Bragoni, MD, PhD; Paola Coiro, MD; Domenico De Angelis, MD; Francesca Romana Fusco, MD; Daniela Morelli, MD; Vincenzo Venturiero, MD Luca Pratesi, MD

From the Fondazione IRCCS Santa Lucia, Rome, Italy.

Correspondence to Dr Stefano Paolucci, Fondazione IRCCS Santa Lucia, Via Ardeatina 306, 00179 Rome, Italy. E-mail s.paolucci{at}hsantalucia.it

Background and Purpose— We sought to assess the specific influence of sex on rehabilitation results.

Methods— A case-control study in 440 consecutive patients with sequelae of first ischemic stroke were enrolled in 2 subgroups (males and females) and matched for severity of stroke (evaluated by means of the Canadian Neurological Scale), age (within 1 year), and onset-admission interval (within 3 days). Functional data, evaluated by means of the Barthel Index and the Rivermead Mobility Index, were compared between subgroups. Logistic regressions were used to clarify the role of sex in affecting global autonomy and mobility.

Results— After rehabilitation treatment, a sex-related difference was observed essentially in the higher levels of response. Indeed, more men than women reached independence in both stair climbing and activities of daily living (ADL), with a higher response and effectiveness on mobility. In multivariate analyses, male patients had a 3 times higher probability than female patients of good autonomy in both stair climbing and ADL (odds ratio [OR]=3.22; 95% CI, 1.67 to 6.18 and OR=2.92; 95% CI, 1.63 to 5.42, respectively). Conversely, female patients had a higher risk of walking with a cane (OR=1.69; 95%, CI 1.04 to 2.76) or of partial autonomy with respect to ADL (OR=1.90; 95% CI, 1.25 to 2.91). No significant difference was found for the other functional parameters.

Conclusions— Female sex is a mildly unfavorable prognostic factor in rehabilitation results after stroke.

Key Words: functional recovery • prognostic factors • rehabilitation • sex • stroke

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