Sex Differences in Stroke Risk Factors, Clinical Profiles, and In-Hospital Outcomes Among Stroke Patients Admitted to the Medical Ward of Dessie Comprehensive Specialized Hospital, Northeast Ethiopia

Abstract

Background

A stroke is a vascular accident that affects both men and women. The threat of stroke and outcome status differ between the sexes. Such data are lacking in Ethiopia. Therefore, this study assessed sex differences in stroke risk factors, clinical profiles, and outcomes in the medical ward of Dessie comprehensive specialized hospital.

Methods

A retrospective cross-sectional study was employed among stroke patients. Medical records with complete information and a confirmed diagnosis of stroke using imaging techniques were included in the study. Using simple random sampling, 344 medical records were selected, 312 of which fulfilled the inclusion criteria. Bivariate and multivariate logistic regression analyses and a chi-square test were employed. The frequency, percentage, and mean and standard deviation of the variables were described using descriptive statistics. Findings with a P-value <0.05 were considered statistically significant.

Results

Most of the patients were above or equal to 45 years old in both sexes. A significantly higher number of male than female patients were aged less than 45 years (p-value-0.001). Younger age (AOR: 2.998, p = 0.000), cigarette smoking (AOR: 2.911, p = 0.009), and Khat chewing (AOR: 3.650, p = 0.001) were risk factors for stroke in males. A higher number of males presented with hemiplegia/hemiparesis 89 (28.5%), aphasia 45 (14.4%), and facial palsy 19 (6.1%). However, more females were unconscious (15.1%). Significant differences were not seen in the stroke outcomes. Furthermore, there were no apparent differences in risk factors for stroke-related mortality.

Conclusion

Males developed stroke at a younger age. Women were older at the time of stroke onset and presented unconscious. More males experienced hemiplegia/hemiparesis, aphasia, and facial palsy. Smoking, drinking, and khat chewing were risk factors for stroke in men. There were no gender differences in the stroke death rate. Therefore, educating the public about stroke risk factors, lifestyle modification, and conducting prospective research is required.

Keywords:

• clinical profiles
• outcome
• risk factors
• sex difference
• stroke
• Dessie hospital

Patient and Public Involvement

The data of the current study were extracted from the patient charts. Therefore, the study subjects and their caregivers were not directly participated in the design of the study protocols. However, the directors of the hospital were involved in the development of data extraction tools. Before data collection, they also reviewed the objectives of the study.

Abbreviations

AOR, adjusted odds ratio; COR, crude odds ratio; CI, confidence interval; DBP, diastolic blood pressure; DCSH, Dessie Comprehensive Specialized Hospital; GCS, Glasgow Coma Scale; RDW, red cell distribution width; SBP, systolic blood pressure; SPSS, Statistical Package for Social Science.

Availability of the Data

All the necessary data that help the results of the current study are incorporated in the manuscript.

Ethics Approval and Consent to Participate

The study complies with the Declaration of Helsinki. Since the study was retrospective, a waiver for ethical approval and consent to participate was obtained from the Institutional Review Board of Wollo University. We received a letter of support from Wollo University’s College of Medicine and Health Sciences to carry out the present study. The director of DCSH was provided with the letter of support, and consent was acquired to view the necessary medical information. Patient confidentiality was guaranteed by ensuring the patient data was “de-identified and anonymous.”

Acknowledgment

It is our great pleasure to thank the record staff and the leaders of DCSH who permitted us to contact documents of the admitted patients. We are also thanking the data collectors and all the study subjects whose information was used for the present study.

Author Contributions

All the authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.

Disclosure

The current study does not contain any conflicts of interest that the authors have declared.

Additional information

Funding

Funding was not obtained from any individual or institution for the study.