The objective of this study was to determine the effect of gender on in-hospital outcomes in ischemic stroke patients undergoing reperfusion therapy.

Acute ischemic stroke patients who underwent reperfusion therapy (intravenous thrombolysis (IVT) or mechanical thrombectomy) at an academic stroke center during 2016 - 2017 were included. Primary outcome measure was improvement in National Institute of Health Stroke Scale (NIHSS) from baseline to 24-hours. Demographic data, stroke characteristics and blood pressure over 24-hours post stroke treatment were collected.

Of 140 patients included in our study, 85 (60.71%) were males and 55 were females with a mean age of 68.8 years. 117 received IVT and 84 received mechanical thrombectomy. Median NIHSS scores at baseline and at 24-hours post reperfusion therapy were 15 and 9 respectively. Mean improvement on NIHSS scores at 24-hours was 4.9 points in males and 2.3 in females (p=0.05). After univariate analysis of predictors of NIHSS improvement, Multivariate regression analysis of candidate variables was performed adjusting for baseline NIHSS and mimimum 24-hour systolic blood pressure that showed male gender to be associated with a 3 point greater improvement in 24-hour NIHSS compared to females (p=0.02).

In our study, female gender showed worse In-hospital outcomes compared to males in patients undergoing reperfusion therapy.