Sex-differences in clinical characteristics and outcome in primary intracerebral haemorrhage

Introduction. Intracerebral haemorrhage (ICH) is characterised by a high risk of mortality and disability. Studies on sex differences in ICH characteristics and outcomes have been inconclusive. The aim of our observational study is to investigate the demographics, aetiology, location, stroke care, and intra-hospital mortality of ICH patients, in order to evaluate sex differences. Methods. Consecutive patients with primary ICH admitted to the Santa Maria della Misericordia Hospital in Perugia, Italy, between 1st January 2009 and 31st March 2017 were included. All patients were classified according to SMASH-U. Intra-hospital mortality rates and their timings were record-ed for each included patient. Results. 1,441 patients were identified on the basis of the 431 ICD-9 code. A total of 727 patients were included in the study; 322 (44.3%) were females. Females were older than males (73.9 vs 70.5, p = 0.001). Hypertensive angiopathy was the most common aetiology for both sexes. Amyloid angio-pathy was more frequent in females, whereas drug-induced ICH was more frequent in males. Additionally, NIHSS was slightly higher for females. No sex difference was observed for intra-hospital mortality. Multivariate analysis performed separately on the sexes suggested that hypertension-relat-ed ICH was independently associated with an increased risk of mortality in females. For both sexes, ICH severity, evalu-ated using the NIHSS, correlated with an increased risk of intra-hospital mortality. Conclusions. In our study, no sex differences in intra-hospital mortality were detected. At ICH onset females tended to be older than males. Hypertension-related ICH tended to be more severe in females and correlated with a higher risk of intra-hospital mortality.