Women are less likely to return to work than men after a major stroke that clogs the blood vessels

April 21, 2022

3 minutes to read

Source / Disclosures

Disclosures:
Hahn reported receiving a personal fee from Bristol-Myers Squibb. Please see the study for all relevant financial disclosures by other authors.


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Women were less likely to return to work after a major vascular occlusion stroke than men, despite similar 90-day functional outcomes, according to study results published in brain attack.

Other indications of not returning to work after a large vascular occlusion stroke included a higher NIH stroke scale after mechanical thrombectomy, occlusion of large vessels due to significant atherosclerosis and a longer hospital stay.

Graphical representation of the data presented in the article

Data were derived from Hahn M, et al. brain attack. 2022; doi: 10.1161/STROKEAHA.121.037386.

Both men and women were more likely to return to work if the stroke was treated with mechanical thrombectomy and venous thrombolysis than with mechanical thrombectomy alone, according to the study.

“Returning to work after a severe stroke is a sign of successful rehabilitation. Resuming pre-stroke levels of life and daily activities is largely associated with a better quality of life,” Marianne Han, MDA clinical scientist at the Department of Neuroscience at Johannes Gutenberg University in Mainz, Germany, said in a press release. “In contrast to most return-to-work studies, we included a large group of subjects treated with mechanical clot removal; they are a subgroup of stroke patients at high risk of severe and persistent disability.”

For the current analysis, the researchers used data from the German Registry of Stroke – Vascular Therapy from 2015 to 2019 to identify 606 patients from the working population who had survived at least 90 days after mechanical thrombectomy for macrovascular occlusive stroke. Participants were compared to determine indications for returning to work after stroke treatment.

Participants were excluded if they were older than 64 years at baseline, had died 90 days, were retired or unemployed, or had been a student before the stroke.

Negative predictions of a return to work

The researchers noted that 35.6% of patients were back to work 90 days after mechanical thrombectomy for stroke (median age, 54 years).

Men who underwent mechanical thrombectomy were often older (55 vs 52 years; s < .001), the probability of smoking increases (39.6% vs. 29.9%; s = .029) and more likely to have atherosclerosis-related major stroke (38.8% vs. 22.2%; s <.001) compared to women in the group.

The absolute proportion of patients who returned to work after mechanical thrombectomy did not differ between men and women (s = .722). According to the study, more women achieved excellent job outcomes by graduation than men (48.1% vs 37.1%; s = .015), and the researchers observed no gender differences in functional outcomes at 90 days.

Independent negative indicators of return to work for 90 days included:

  • female gender (OR = 0.427; 95% CI, 0.229-0.794; s = .007);
  • Higher NIH score for stroke 24 hours after mechanical thrombectomy (OR = 0.775; 95% CI, 0.705-0.852; s <.001);
  • Large vessel obstruction due to significant atherosclerosis (odds ratio = 0.558; 95% confidence interval, 0.312–0.997; s = .049); And
  • Longer hospital stay (odds ratio per day = 0.93; 95% CI, 0.868–0.998; s = .043).

“After examining the data further, we also found that the women in our group were younger at the time of their stroke, were more likely to be non-smokers and were more likely to have no significant existing disability at hospital discharge compared to the men in our study,” Hahn said in the statement. . “Although there were more of these positive characteristics of returning to work, we did not observe a higher rate of re-employment among women before considering these differences.”

Positive predictions of returning to work

Positive indices of return to work for 90 days included a modified Rankin scale score of 0 to 1 at 90 days (OR = 11.335; 95% CI, 4.864-26.415; s < .001) and combined treatment with venous thrombosis (OR = 1.904; 95% CI, 1.046–3.466; s = .035).

“There is more to re-employment after mechanical thrombectomy than functional outcomes,” Han said in the statement. “Targeted occupational and workplace rehabilitation interventions have been shown to improve return to work rates. Previous studies have also found that returning to work is associated with increased well-being, self-esteem, and life satisfaction.”

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