Wednesday, July 16, 2008

New study finds women with heart disease, diabetes have worse stroke outcomes
By Kelly Winget

A new Duke and DCRI study was one of the first longitudinal studies to analyze detailed clinical outcomes in women who have had strokes. Researchers found that women who had other pre-existing health conditions were more likely to have poor stroke outcomes, particularly if they had coronary heart disease or diabetes.

The DCRI's Kristin Newby was one of the researchers on the study. The results were published in the July 1 issue of Stroke.

Previous studies have indicated that women tend to have worse stroke outcomes than men do, and as a result many women need greater levels of assistance following the stroke. Although women who have had strokes are on average older than men who have strokes, researchers have found that even after adjusting for age, women still had poorer outcomes but clinicians did not have an understanding of which other health conditions were most associated with the poorer stroke outcomes.

Researchers evaluated pre-stroke health conditions in 133 women admitted for acute ischemic stroke to see if these other conditions were associated were higher modified Rankin Scores 90 days after having a stroke. Doctors use the modified Rankin Score to assign a score between 0 and 6 to patients who have had a stroke. The score identifies the severity of symptoms and the level of assistance a person needs following a stroke.

For the study, researchers used the Charlson Index to identify which health conditions are most likely to result in higher Rankin Scores. The Charlson Index weighs health conditions based on their association with one-year mortality rates.

Researchers found that higher index scores from other health conditions were associated with women having poorer stroke outcomes. Particularly, coronary heart disease and diabetes were the most closely associated with women who had higher Rankin Scores 90 days following the stroke.