Abstract WP348: Difference Risk Factors in Sex Difference Between Patients With First-Ever and Recurrent Strokes in Shanghai

Abstract

Objective: The underlying mechanisms of high recurrence of ischemic stroke in Chinese population are unclear. Our study is to determine sex differences in recurrent stroke and hospital mortality after a recurrent stroke in Chinese population. Methods: Shanghai Stroke Service System is a quality improvement project based on the EHR system. All stroke population who were hospitalized in 2018 for acute ischemic stroke within 7 days were prospectively extracted. The ORs for recurrent ischemic stroke were calculated with adjustment for demographics and risk factors. Results: Among 21,805 acute ischemic stroke patients in Shanghai Stroke Service System, having an ischemic stroke (mean age 69 years [SD 12 years], 63.7% male). About 21.8% of patients had a recurrent stroke (95%CI 21.3-22.4%). The multivariable logistic regression suggested that recurrent stroke population have more vascular risk factors, compared to first-ever stroke population. Furthermore, the sex differences in risk factors were gradually increasing, but reduction in smoking (35% vs. 28% in male; 2% vs 1.8% in female) and alcoholic status (22% vs. 18% in male; 1.9% vs 1.4% in female). The ORs of recurrent rate in male stroke population compared with in female was 0.74 (95% CI 0.62-0.79) after multivariable adjusted. The hospital mortality after recurrent stroke for male and female was 2.1% (95% CI 1.6%-2.6%) and 3.1% (95% CI 2.3%-4.1%), respectively. The multivariable-adjusted relative risk for hospitalization mortality of a recurrent stroke was 1.19 (95% CI 0.94-1.50). There is no significant difference impact on mortality between sex (aOR 1.08, 95% 0.72-1.63). Conclusion: The vascular risk factors in recurrent stroke population were mostly increasing, compared to those with first-ever stroke. However, the rates of smoking and alcoholism were reduced in male but not in female. The hospitalization mortality rate in recurrent stroke was similar to those with first-ever stroke population.