Women were less likely to return to work after a severe stroke

Date:
April 21, 2022
Source:
American Heart Association
Summary:
A new study has found that after a severe stroke treated with
mechanical clot removal, about one third of stroke survivors
resumed work three months later. Women were about half as likely
to return to work three months after a severe stroke compared to
men. The likelihood of returning to work for both men and women
after a severe stroke was higher if they were treated with combined
mechanical clot removal and clot-busting stroke medications as
compared to mechanical clot removal alone.



FULL STORY ========================================================================== According to new research, about one third of people who had a large
vessel (severe) ischemic stroke, treated with mechanical clot removal,
resumed work three months after stroke treatment. However, women were
about half as likely to return to work after a severe stroke compared to
men, according to the study published today in Stroke, the peer-reviewed, flagship journal of the American Stroke Association, a division of the
American Heart Association.


==========================================================================
A stroke due to a blockage in a large blood vessel is an indicator of
a severe stroke and the potential for continuing loss of function,
which makes it less likely people will return to work. According to
the American Heart Association, while ischemic stroke accounts for 87%
of strokes in the United States, large vessel occlusions only account
for approximately 24% -- 46% of ischemic strokes.

Endovascular therapy (mechanical clot removal) and clot-busting
medications are now a standard treatment for select patients with
severe stroke. Endovascular therapy involves threading a slim catheter
through a vessel in the leg to mechanically remove a clot blocking a
brain vessel. In 2018, the American Heart Association stroke treatment guidelines were updated to recommend mechanical clot removal for select
stroke patients to improve the odds of functional recovery.

"Returning to work after a severe stroke is a sign of successful rehabilitation. Resuming pre-stroke levels of daily living and activities
is highly associated with a better quality of life," said Marianne Hahn,
M.D., lead study author and a clinician scientist in the department
of neurology at Johannes Gutenberg University in Mainz, Germany. "In
contrast to most return- to-work studies, we included a large cohort of
only people treated with mechanical clot removal; they are a subgroup
of stroke patients at high risk for severe, persisting deficits."
Researchers examined data from the German Stroke Registry -- Endovascular Treatment Study Group. The analysis included more than 600 men and women
(28% women), ages 18- to 64-years-old who had a large vessel ischemic
stroke between 2015 and 2019.

All study participants were employed prior to their stroke and were
treated with mechanical thrombectomy. More than half of the study
participants also received intravenous thrombolysis (clot-busting
medication).



========================================================================== Researchers compared the people who returned to work 90 days after
being treated with mechanical thrombectomy to those who did not resume
work. After accounting for age, sex, health conditions, type and severity
of stroke, and treatment characteristics, the analysis found:
* About one-third of the stroke survivors resumed work three months
later.

* The amount of persistent functional deficits after stroke was
the main
reason people were not able to return to work.

* Women were 58% less likely to return to work three months after
mechanical thrombectomy compared to men.

* Individuals who were treated with both mechanical thrombectomy and
intravenous thrombolysis were almost twice as likely to return
to work compared to the individuals who had undergone mechanical
thrombectomy only.

"After examining the data further, we also found that women in our
cohort were younger at the time of their stroke, were more likely to
be non-smokers and were more likely to have no existing significant
disability when discharged from the hospital compared to the men in
our study. Despite having more of these favorable characteristics for
return to work, we did not observe a higher re-employment rate among
women before considering these differences," Hahn said.

The researchers noted further study is needed to explain the discrepancy between men and women re-entering the workforce after a major stroke. More intensive and supportive vocational rehabilitation programs may be
valuable to help women return to work.

"There is more to re-employment after mechanical thrombectomy than
functional outcomes," Hahn said. "Targeted vocational and workplace rehabilitation interventions have been shown to improve rates of return
to work. And previous studies have also found that returning to work is associated with increased well-being, self-esteem and life satisfaction."
The study authors believe their findings may be transferable to other
countries with similar health care and rehabilitation systems. However, confirmation and in-depth analyses of national policies are necessary to explain the observation since there may be differences, such as social
services and benefits, which have been shown to influence return to work.

The study was limited in that the data lacked detailed information
about types of jobs and available employment opportunities. The German
Stroke Registry does not include social determinants of health, and
whether an individual was re- employed at the same job or working full-
or part-time. Researchers noted these limitations may help explain and
play a role in whether people returned to work after a severe stroke.

In the U.S., stroke is the fifth leading cause of death and a leading
cause of disability, according to the latest data from the American
Heart Association.

To recognize stroke symptoms requiring immediate medical attention,
the American Stroke Association recommends everyone remember the acronym F.A.S.T.

for Face drooping, Arm weakness, Speech difficulty, Time to call 9-1-1.

Co-authors are Sonja Gro"schel, M.D.; Eyad Hayani, M.D.; Marc
A. Brockmann, M.D.; Muthuraman Muthuraman, Ph.D.; Klaus Gro"schel, M.D.;
and Timo Uphaus, M.D.

The researchers reported no outside funding sources for this study.


========================================================================== Story Source: Materials provided by American_Heart_Association. Note:
Content may be edited for style and length.


========================================================================== Journal Reference:
1. Marianne Hahn, Sonja Gro"schel, Eyad Hayani, Marc A. Brockmann,
Muthuraman Muthuraman, Klaus Gro"schel, Timo Uphaus, Joachim
Ro"ther, Bernd Eckert, Michael Braun, Gerhard F. Hamann,
Eberhard Siebert, Christian H Nolte, Sarah Zweynert, Georg
Bohner, Jo"rg Berrouschot, Albrecht Bormann, Christoffer Kraemer,
Martina Petersen, Florian Sto"gbauer, Tobias Boeckh-Behrens, Silke
Wunderlich, Alexander Ludolph, Karl-Heinz Henn, Christian Gerloff,
Jens Fiehler, Go"tz Thomalla, Anna Alegiani, Franziska Dorn,
Gabor Petzold, Waltraud Pfeilschifter, Fee Keil, Martin Dichgans,
Steffen Tiedt, Lars Kellert, Christoph Trumm, Ulrike Ernemann,
Sven Poli. Sex Disparities in Re-Employment in Stroke Patients
With Large Vessel Occlusion Undergoing Mechanical Thrombectomy.

Stroke, 2022; DOI: 10.1161/STROKEAHA.121.037386 ==========================================================================

Link to news story: https://www.sciencedaily.com/releases/2022/04/220421094107.htm

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