Abstract WMP29: Sex Differences On The Importance Of Multimorbidity In Post-stroke Disability:the Taiwan Stroke Registry

Abstract

Background: Experiencing a clinical stroke may further aggravate the clinical condition of patients with multimorbidity and pose significant challenges regarding recommended poststroke therapies. However, there is limited evidence regarding the impact of multimorbidity on long-term disability in stroke patients, or whether any associations differ by sex. Hypotheses: Clusters of multimorbidity are associated with post-stroke disability. The association may depend on sex membership. Methods: In the Taiwan Stroke Registry study, 9818 patients with their first-ever recorded ischemic stroke were examined. Employing a hierarchical clustering approach, clusters of multimorbidity were generated based on 16 risk factors and were characterized using the observed/expected prevalence ratio ≥1.5 and the prevalence exclusivity measure ≥25%. Post-stroke disability was assessed using the mRS and categorized into less (mRS <3) vs. more disability (mRS ≥3) over 12 months. The association between clusters of multimorbidity and post-stroke disability adjusted for age, sex, education, and stroke severity (NIHSS) was determined using logistic regression models, overall and stratified by sex. Results: Patients with a cluster profile of diabetes, peripheral artery disease and uremia had more disability than patients with a healthier cluster profile (Table 1). The association only remained significant in males, who had a higher multimorbidity burden, but not in females who more frequently had more severe strokes and more severe post-stroke disability. Conclusion: Patients with multimorbidity involving diabetes, peripheral artery disease and uremia have greater post-stroke disability and may require a more targeted rehabilitative approach. Certain clusters of multimorbidity may be more important for long-term post-stroke disability outcomes in males than in females.