{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T04:41:28Z","timestamp":1791607288945,"version":"4.3.4"},"reference-count":29,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"10","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Stroke"],"published-print":{"date-parts":[[2017,10]]},"abstract":"<jats:sec>\n            <jats:title>Background and Purpose\u2014<\/jats:title>\n            <jats:p>Several studies have reported unexplained worse outcomes after stroke in women but none included the full spectrum of symptomatic ischemic cerebrovascular events while adjusting for prior handicap.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods\u2014<\/jats:title>\n            <jats:p>Using a prospective population-based incident cohort of all transient ischemic attack\/stroke (OXVASC [Oxford Vascular Study]) recruited between April 2002 and March 2014, we compared pre-morbid and post-event modified Rankin Scale score (mRS) in women and men and change in mRS score 1 month, 6 months, 1 year, and 5 years after stroke. Baseline stroke-related neurological impairment was measured with the National Institutes of Health Stroke Scale.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results\u2014<\/jats:title>\n            <jats:p>Among 2553 patients (50.6% women) with a first transient ischemic attack\/ischemic stroke, women had a worse handicap 1 month after ischemic stroke (age-adjusted odds ratio for mRS score, 1.35; 95% confidence interval, 1.12\u20131.63). However, women also had a higher pre-morbid mRS score compared with men (age-adjusted odds ratio, 1.58; 95% confidence interval, 1.36\u20131.84). There was no difference in stroke severity when adjusting for age and pre-morbid mRS (odds ratio, 1.10; 95% confidence interval, 0.90\u20131.35) and no difference in the pre-\/poststroke change in mRS at 1 month (age-adjusted odds ratio, 1.00; 95% confidence interval, 0.82\u20131.21), 6 months, 1 year, and 5 years. Women had a lower mortality rate, and there was no sex difference in risk of recurrent stroke.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions\u2014<\/jats:title>\n            <jats:p>We found no evidence of a worse outcome of stroke in women when adjusting for age and pre-morbid mRS. Failure to account for sex differences in pre-morbid handicap could explain contradictory findings in previous studies. Properties of the mRS may also contribute to these inconsistencies.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/strokeaha.117.018187","type":"journal-article","created":{"date-parts":[[2017,8,11]],"date-time":"2017-08-11T01:00:34Z","timestamp":1502413234000},"page":"2731-2738","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":76,"title":["Confounding by Pre-Morbid Functional Status in Studies of Apparent Sex Differences in Severity and Outcome of Stroke"],"prefix":"10.1161","volume":"48","author":[{"given":"Christel","family":"Renoux","sequence":"first","affiliation":[{"name":"From the Centre for Clinical Epidemiology, Lady Davis Institute for Medical Research, Jewish General Hospital, Montr\u00e9al, Qu\u00e9bec, Canada (C.R., J.C.); Departments of Neurology and Neurosurgery (C.R.) and Epidemiology and Biostatistics (C.R.), McGill University, Montr\u00e9al, Qu\u00e9bec, Canada; and Center for Prevention of Stroke and Dementia, Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, University of Oxford, United Kingdom (C.R., L.L., A.G., L.S., P.M.R.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janie","family":"Coulombe","sequence":"additional","affiliation":[{"name":"From the Centre for Clinical Epidemiology, Lady Davis Institute for Medical Research, Jewish General Hospital, Montr\u00e9al, Qu\u00e9bec, Canada (C.R., J.C.); Departments of Neurology and Neurosurgery (C.R.) and Epidemiology and Biostatistics (C.R.), McGill University, Montr\u00e9al, Qu\u00e9bec, Canada; and Center for Prevention of Stroke and Dementia, Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, University of Oxford, United Kingdom (C.R., L.L., A.G., L.S., P.M.R.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linxin","family":"Li","sequence":"additional","affiliation":[{"name":"From the Centre for Clinical Epidemiology, Lady Davis Institute for Medical Research, Jewish General Hospital, Montr\u00e9al, Qu\u00e9bec, Canada (C.R., J.C.); Departments of Neurology and Neurosurgery (C.R.) and Epidemiology and Biostatistics (C.R.), McGill University, Montr\u00e9al, Qu\u00e9bec, Canada; and Center for Prevention of Stroke and Dementia, Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, University of Oxford, United Kingdom (C.R., L.L., A.G., L.S., P.M.R.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aravind","family":"Ganesh","sequence":"additional","affiliation":[{"name":"From the Centre for Clinical Epidemiology, Lady Davis Institute for Medical Research, Jewish General Hospital, Montr\u00e9al, Qu\u00e9bec, Canada (C.R., J.C.); Departments of Neurology and Neurosurgery (C.R.) and Epidemiology and Biostatistics (C.R.), McGill University, Montr\u00e9al, Qu\u00e9bec, Canada; and Center for Prevention of Stroke and Dementia, Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, University of Oxford, United Kingdom (C.R., L.L., A.G., L.S., P.M.R.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Louise","family":"Silver","sequence":"additional","affiliation":[{"name":"From the Centre for Clinical Epidemiology, Lady Davis Institute for Medical Research, Jewish General Hospital, Montr\u00e9al, Qu\u00e9bec, Canada (C.R., J.C.); Departments of Neurology and Neurosurgery (C.R.) and Epidemiology and Biostatistics (C.R.), McGill University, Montr\u00e9al, Qu\u00e9bec, Canada; and Center for Prevention of Stroke and Dementia, Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, University of Oxford, United Kingdom (C.R., L.L., A.G., L.S., P.M.R.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter M.","family":"Rothwell","sequence":"additional","affiliation":[{"name":"From the Centre for Clinical Epidemiology, Lady Davis Institute for Medical Research, Jewish General Hospital, Montr\u00e9al, Qu\u00e9bec, Canada (C.R., J.C.); Departments of Neurology and Neurosurgery (C.R.) and Epidemiology and Biostatistics (C.R.), McGill University, Montr\u00e9al, Qu\u00e9bec, Canada; and Center for Prevention of Stroke and Dementia, Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, University of Oxford, United Kingdom (C.R., L.L., A.G., L.S., P.M.R.)."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.108.540781"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(08)70193-5"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1052-3057(03)00042-9"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e3181d5a4bc"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(04)16405-2"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.19.5.604"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.106.480723"},{"key":"e_1_3_4_9_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.20.7.864"},{"key":"e_1_3_4_10_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.24.1.35"},{"key":"e_1_3_4_11_2","doi-asserted-by":"publisher","DOI":"10.1080\/01621459.1999.10474144"},{"key":"e_1_3_4_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jstrokecerebrovasdis.2005.06.002"},{"key":"e_1_3_4_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jstrokecerebrovasdis.2006.11.002"},{"key":"e_1_3_4_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jstrokecerebrovasdis.2013.11.003"},{"key":"e_1_3_4_15_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e3181d5a48f"},{"key":"e_1_3_4_16_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.0000157662.09551.e5"},{"key":"e_1_3_4_17_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.108.542894"},{"key":"e_1_3_4_18_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.0000078562.82918.F6"},{"key":"e_1_3_4_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejim.2012.10.004"},{"key":"e_1_3_4_20_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-016-8042-2"},{"key":"e_1_3_4_21_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0056459"},{"key":"e_1_3_4_22_2","doi-asserted-by":"publisher","DOI":"10.1161\/hs1201.100209"},{"key":"e_1_3_4_23_2","doi-asserted-by":"publisher","DOI":"10.1159\/000052130"},{"key":"e_1_3_4_24_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.115.001967"},{"key":"e_1_3_4_25_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.31.8.1833"},{"key":"e_1_3_4_26_2","doi-asserted-by":"publisher","DOI":"10.1159\/000082999"},{"key":"e_1_3_4_27_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.0000068410.07397.D7"},{"key":"e_1_3_4_28_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.0000083534.81284.C5"},{"key":"e_1_3_4_29_2","first-page":"A13","article-title":"Sex differences in stroke recovery.","volume":"2","author":"Lai SM","year":"2005","unstructured":"Lai SM, Duncan PW, Dew P, Keighley J. 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