Donate Help Contact The AHA Sign In Home
American Heart Association
Stroke
Search: search_blue_button Advanced Search
Published Online
on February 10, 2009

Stroke. 2009
Published online before print February 10, 2009, doi: 10.1161/STROKEAHA.108.543819
A more recent version of this article appeared on April 1, 2009
Free Article
This Article
Free upon publication Free Article
Right arrow Full Text (PDF)
Right arrow All Versions of this Article:
40/4/1134    most recent
STROKEAHA.108.543819v1
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrowRequest Permissions
Citing Articles
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Palnum, K. D.
Right arrow Articles by Johnsen, S. P.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Palnum, K. D.
Right arrow Articles by Johnsen, S. P.
Right arrowPubmed/NCBI databases
Medline Plus Health Information
*Stroke
Related Collections
Right arrow Acute Cerebral Hemorrhage
Right arrow Acute Cerebral Infarction
Right arrow Emergency treatment of Stroke
Right arrow Epidemiology

Submitted on November 22, 2008
Accepted on December 3, 2008

Sex-Related Differences in Quality of Care and Short-Term Mortality Among Patients With Acute Stroke in Denmark. A Nationwide Follow-Up Study

Kaare D. Palnum MD*; Grethe Andersen MD, Dr Med Sci; Annette Ingeman MHSc; Birgitte R. Krog MPH; Paul Bartels MD; and Søren P. Johnsen MD, PhD

From the Department of Clinical Epidemiology (K.D.P., S.P.J.), Aarhus University Hospital, Denmark; the Department of Neurology (G.A.), Aarhus University Hospital, Aarhus Hospital, Denmark; and the Coordinating Secretariat (NIP) (A.I., B.R.K., P.B.), County of Aarhus, Denmark.

* To whom correspondence should be addressed. E-mail: kdp{at}dce.au.dk.

Background and Purpose—Sex may predict level of care and successive outcome among patients with stroke. We examined fulfillment of quality of care criteria according to sex and possible impact of any sex-related differences on short-term mortality in a population-based nationwide follow-up study in Denmark.

Methods—We identified 29 549 patients admitted with stroke between January 2003 and October 2005 in the Danish National Indicator Project. Data on 30- and 90-day mortality were obtained from The Civil Registration System. We compared proportions of patients receiving adequate care between sexes, as measured by admission to a specialized stroke unit, administration of antiplatelet or anticoagulant therapy, examination with CT/MRI scan, and assessment by a physiotherapist, an occupational therapist, and of nutritional risk. Further, we computed 30- and 90-day mortality rate ratios (MRR), adjusted for patient characteristics, fulfillment of quality of care criteria, and department.

Results—The proportion of patients who received adequate care was either slightly lower or similar among women when compared to men. The relative risks (RR) of receiving specific components of care ranged from 0.84 (95% confidence interval [CI]:0.74 to 0.96) to 1.01 (95% CI:0.96 to 1.06) when comparing sexes. The adjusted mortality rate ratios were lower among women and adjustment for fulfillment of quality of care criteria had only marginal impact.

Conclusions—There appear not to be any substantial sex-related differences in acute hospital care among patients with stroke in Denmark. The lower female short-term mortality is therefore most likely explained by other factors.


Key words: quality of care • prognosis • sex • stroke