Letter by Ganesh and Renoux Regarding Article, “Sex Differences and Functional Outcome After Intravenous Thrombolysis”
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To the Editor:
We read the recent discussion on sex differences in functional outcome in thrombolysis recipients, with interest.1 We wish to address the issue of how premorbid disability was accounted for in the study that sparked this discussion.2
In their retrospective study of thrombolysis recipients from 12 European centers, Spaander et al2 compared 3-month modified Rankin Scale (mRS) scores in men versus women. Women were older and had more premorbid disability (mRS score >2), atrial fibrillation, hypertension, more severe strokes, and longer onset-to-needle time. Adjusting for these factors in a logistic regression, the authors concluded that women more often had poor functional outcome (mRS score, 3–6). On univariate analysis, the overall mRS score distribution in women also appeared more unfavorable. However, there was no association between sex and functional outcome once data were stratified by age, and women had lower mortality on multivariable …