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. 2024 Sep 12;24(1):2488.
doi: 10.1186/s12889-024-20006-w.

Females with diabetes have a higher risk of ischemic stroke readmission: a retrospective cohort study

Hua Meng #  1   2 , Ting Pan #  1   2 , Dongfeng Pan  3 , Xinya Su  1   2 , Wenwen Lu  1   2 , Xingtian Wang  1   2 , Zhuo Liu  1   2 , Yuhui Geng  1   2 , Xiaojuan Ma  1   2 , Peifeng Liang  4
Affiliations

Females with diabetes have a higher risk of ischemic stroke readmission: a retrospective cohort study

Hua Meng et al. BMC Public Health. .

Abstract

Background: There are significant sex differences in the incidence of stroke or diabetes mellitus. However, little is known about sex differences in stroke rehospitalization among diabetic patients.

Object: To explore the sex differences in short-term and long-term rehospitalization of ischemic stroke patients with Type 2 diabetes mellitus.

Methods: A retrospective cohort study was conducted from 2017 to 2021. The rehospitalization events of ischemic stroke patients with diabetes mellitus were identified by the national unified Electronic Health Record. Propensity score matching was applied to adjust for multiple covariates, and LASSO regression was used to screen for independent variables. Cox proportional hazards model was utilized to analyze the different sex in short-term (90 days, 1 year) and long-term (5 years) rehospitalization in ischemic stroke patients with type 2 diabetes mellitus.

Result: A total of 10,724 ischemic stroke patients were included in this study, of whom 5,952 (55.5%) were males. After a 1:1 propensity score matching, there were 3,460 males and 2,772 females. After adjusting for confounding factors, female patients with type 2 diabetes had an increased risk of ischemic stroke rehospitalization at 90 days (HR: 1.94, 95%CI: 1.13-3.33, P < 0.05), 1 year (HR: 1.65, 95%CI:1.22-2.23, P = 0.001), and 5 years (HR: 1.58, 95%CI: 1.26-1.97, P < 0.001). However, there was no significant relationship between male patients with type 2 diabetes and the risk of ischemic stroke rehospitalization, either in the short or long term.

Conclusion: Females with type 2 diabetes mellitus have a higher risk of ischemic stroke rehospitalization in both the short-term and long-term.

Keywords: Ischemic stroke; Rehospitalization; Sex differences; Type 2 diabetes.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
The follow chart of patient selection
Fig. 2
Fig. 2
Kaplan-Meier curve of male cohort (A, B) and female cohort (C, D) (PSM: Propensity score matching)
Fig. 3
Fig. 3
Forest plot of influencing factors of rehospitalization in male ischemic stroke patients at different periods
Fig. 4
Fig. 4
Forest plot of influencing factors of rehospitalization in female ischemic stroke patients at different periods
See this image and copyright information in PMC

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