Gender Differences in Risk Factor Profiles and Predictors of Poor Outcomes among Acute Stroke Patients: A Pilot Study from Egypt

Background and Objective: Stroke remains a leading cause of mortality and long-term disability worldwide, with significant socioeconomic implications. This study aimed to investigate gender-based differences in acute stroke patients regarding baseline characteristics, clinical presentation, and predictors of poor outcome in an Egyptian population. Methods: We prospectively recruited 116 acute stroke patients admitted to the stroke unit at Cairo University Hospitals from January to June 2020. Detailed data on demographics, clinical characteristics, diagnostic workup, hospital course, and functional outcomes were collected. Poor outcome was defined as a modified Rankin Scale (mRS) ≥ 3 at discharge. Data were analyzed using SPSS version 28 (IBM Corp., Armonk, NY, USA). Results: The study included 60 males (51.7%) and 56 females (48.3%) with a median age of 62 years. Atrial fibrillation (32.1% vs 15%, p = 0.029) and obesity (80.3% vs 66.7%, p = 0.010) were more common in females, while smoking history was more common in males (70% vs 7.1%, p < 0.001). Females had higher levels of total cholesterol (median 238 vs 189 mg/dL, p = 0.007) and triglycerides (median 160 vs 141 mg/dL, p = 0.026). Using regression analysis, dysphagia remained an independent predictor of poor outcome in both females (OR : 23.4, 95% CI : 2.521-217.2, p=0.006) and males (OR : 15.769, 95% CI : 1.686-147.509, p=0.016). Conclusion: This pilot study highlights important gender differences in stroke charachteristics and emphasizes the need for a wide-scale stroke registry in Egypt. The strong association between dysphagia and poor outcomes in both genders highlights the importance of early dysphagia screening and management in acute stroke care.