Table 3.

Analyses of Heterogeneity in Sex Difference in Mortality at 1 y After Stroke Among 13 Population-Based Studies

Variables of InterestNo. of StudiesNo. of Death (n/N)UnadjustedAdjusted*
MenWomenI2, %PHMRR (95% CI)PsubgroupI2 (%)PHMRR (95% CI)Psubgroup
Study-level characteristics
 Geographic region
  Australasia3380/1339584/158322.60.2751.35 (1.10–1.65)0.6180.00.7940.73 (0.57–0.94)0.479
  Europe71684/58302297/656436.20.1521.35 (1.21–1.50)50.70.0580.80 (0.68–0.94)
  South America2103/558105/50339.10.2001.06 (0.60–1.86)53.70.1420.78 (0.38–1.59)
  Caribbean176/285113/295NA1.0001.65 (1.19–2.29)NA1.0001.15 (0.79–1.68)
 Income group
  HIC102064/71692881/814726.40.2011.34 (1.23–1.47)0.94832.00.1520.79 (0.69–0.89)0.186
  LMIC3179/843218/79849.80.1371.31 (0.92–1.86)33.30.2230.98 (0.69–1.39)
 Person-years
  Actual91394/54501940/606020.10.2641.35 (1.22–1.49)0.9040.00.4710.74 (0.66–0.84)0.023
  Estimated4849/25621159/288550.80.1071.37 (1.08–1.73)24.20.2660.97 (0.80–1.18)
 Death registries
  Yes71042/39121482/447348.40.0711.37 (1.16–1.62)0.8310.00.4520.77 (0.68–0.88)0.594
  No61201/41001617/44720.00.4661.31 (1.20–1.43)56.50.0430.83 (0.68–1.02)
 Age difference§
  ≤4.5 yr5934/30021149/31430.00.5561.21 (1.09–1.34)0.0575.80.3740.87 (0.75–1.01)0.673
  >4.5 yr81309/50101950/580220.10.2701.44 (1.30–1.59)46.00.0730.80 (0.67–0.95)
 Severity instrument
  NIHSS7687/2561959/273115.50.3111.41 (1.24–1.61)0.1980.00.6390.78 (0.66–0.93)0.345
  Barthel Index176/285113/295NA1.0001.65 (1.19–2.29)NA1.0001.15 (0.79–1.68)
  Others51480/51662027/591914.90.3191.27 (1.15–1.39)64.30.0240.79 (0.64–0.97)
 SAH data
  Yes112132/76662898/848128.50.1741.32 (1.32–1.45)0.21038.50.0930.79 (0.69–0.90)0.166
  No2111/346201/4640.00.9711.63 (1.23–2.15)0.00.7661.08 (0.77–1.52)
 Sample size
  ≤250249/13839/1260.00.5740.82 (0.50–1.32)0.1340.00.7450.53 (0.29–0.96)0.321
  >25010006451/1730643/18760.00.5891.44 (1.26–1.65)58.30.0350.88 (0.67–1.16)
  >100051743/61442417/694340.90.1491.33 (1.20–1.48)0.00.4220.82 (0.74–0.90)
Participant-level characteristics#
 Stroke type
  IS131551/64192076/699339.00.0731.33 (1.20–1.49)Ref35.50.0981.01 (0.91–1.12)Ref
  ICH13443/1001552/103526.20.1791.35 (1.09–1.66)0.89451.20.0171.22 (0.96–1.55)0.940
  SAH1087/241137/3588.30.3651.11 (0.77–1.60)0.31878.0<0.0010.85 (0.40–1.80)0.390
  Undetermined12172/351364/5590.00.6331.53 (1.19–1.98)0.37080.9<0.0010.91 (0.56–1.47)0.449
 Age group
  ≤6513334/2295243/16200.00.5041.06 (0.89–1.27)Ref
  >65–7513537/2350446/19350.00.4891.08 (1.00–1.17)0.337
  >75131372/33672410/53900.00.6031.12 (0.99–1.28)0.404
  • Bold denotes statistically significant results. CI indicates confidence interval; HIC, high-income country; ICH, intracerebral hemorrhage; IS, ischemic stroke; LMIC, Low- and middle-income country; MRR, mortality rate ratio between women and men; NA, not applicable; NIHSS, National Institutes of Health Stroke Scale; PH, P value of heterogeneity; Psubgroup, P value for subgroup analysis; Ref, reference group; SAH, subarachnoid hemorrhage.

  • * MRR adjusted for actual confounders, but estimates for stroke type adjusted for age only.

  • Estimates were performed using 2-stage method analysis.

  • Low- and middle-income country (LMIC) group included studies conducted in Martinique, Joinville, and Mãtao.

  • § Indicates difference in median age at onset between women and men.

  • Other instruments including Glasgow Coma Scale and loss of consciousness.

  • # Estimates were performed using multivariate random-effect meta-analyses from a pooled data set.