The Qatar stroke database is a prospective study, which began enrolling patients in 2014. We collected data on the demographics, clinical presentation, investigations, treatments, hospital complications and outcome (measured as 90-days modified Rankin Score [mRS]) on all patients admitted with acute stroke to the Hamad General Hospital where ~95% of stroke patients in Qatar are admitted. Multivariate analysis of risk factors, stroke type and severity, and in-hospital complications were compared to determine 90-days and one-year outcome in men and women.

7300 patients (F: 1406 {19.3%} and M: 4894 {80.7%}, mean age 55.1±13.3 {F 61.6±15.1, M 53.5±12.3; p<0.001}) were admitted with acute ischemic stroke. Significantly fewer females presented within the 4.5 hours of onset [F: 29% versus M:  32.8%; p = 0.01]. Women had more severe stroke [NIHSS >10; F: 19.9 % versus M:  14.5 %; P <0.001]. Thrombolysis was less likely to be offered to women [F: 9.8% versus M: 12.1%; p 0.02]. Medical complications were more common in women [F: 11.7% versus M: 7.4%; p<0.001] and females had a prolonged length of stay in hospital [F: 6.4±7.6 versus M: 5.5±6.8; p<0.001]. 90-days good recovery was less frequent in women [mRS of 0-2: F: 53.3% versus M: 71.2%; p<0.001]. Poor prognosis increased with age.

In this large series of prospectively collected acute stroke patients from Qatar, our study reveals that women are more likely to have a poor outcome when compared to men. Although there was a higher incidence of obesity and previous CAD in women, we were unable to explain the reasons for the poor outcome at 90 days and one year.