Sex differences in stroke outcomes: a retrospective analysis

Sex-based differences in stroke outcomes have been well documented, with women often experiencing more severe strokes and poorer recoveries. Study design and setting: Retrospective cohort study at Milton Keynes University Hospital including patients admitted with acute stroke from 2022 to 2023. Population: All adult patients with confirmed stroke during the period; no exclusions by age or sex. During the study period the youngest case was 31 years old and no patients younger than 31 were identified. Data collection: From electronic records, extracting sex, age (the youngest age in the studied period was 31), stroke severity (NIHSS at admission), functional status (mRS before and after stroke, assessed by the stroke team in-person during admission and at discharge), and early palliative care decisions within 72 h. Data analysed with SPSS statistics. Women were significantly older than men (mean age: 78.5 vs. 69.0 years; p = 0.0001). Pre-stroke mRS scores indicated greater baseline disability in women (p = 0.0001). Although stroke severity was similar overall between sexes (p = 0.246), women aged 31–60 had higher rates of moderate to severe strokes. There were no significant differences in post-stroke recovery (p = 0.333). Early palliative care was more common among women aged 31+ (3.8% vs. 3.5% in men), though this was not statistically significant. Women, particularly those aged 31–60, had greater baseline disability and tended to experience more severe strokes. These findings highlight the importance of considering sex-specific factors in stroke management.