There are several controversies regarding the role of sex and gender in the pathophysiology and management of acute stroke. Assessing the role of sex, i.e., biological/pathophysiological factors, and gender, i.e., sociocultural factors, in isolation is often not possible since they are closely intertwined with each other. To complicate matters even more, the functional baseline status of women and men at the time of their first stroke is substantially different, whereby women have, on average, a poorer reported/ascertained baseline function compared to men. These differences in baseline variables account for a large part of the differences in post-stroke outcomes between women and men. Adjusting for these baseline differences is difficult, and in many cases, residual confounding cannot be excluded. Despite these obstacles, a better understanding of how patient sex and gender differences influence acute stroke and stroke care pathways is crucial to avoid biases and allow us to provide the best possible care for all acute stroke patients. Disregarding patient sex and gender on one hand and ignoring potential confounding factors in sex- and gender-stratified analyses on the other hand, may cause researchers to come to erroneous conclusions and physicians to provide suboptimal care. This review outlines sex- and gender-related factors in key aspects of acute stroke, including acute stroke epidemiology, diagnosis, access to care, treatment outcomes, and post-acute care. We also attempt to outline knowledge gaps, which deserve to be studied in further detail, and practical implications for physicians treating acute stroke patients in their daily practice.

中文翻译：

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中风的性别差异及其在急性护理中的实际意义。

关于性和性别在急性卒中的病理生理学和管理中的作用存在一些争议。评估性别的作用，即生物/病理生理因素，以及性别，即社会文化因素，通常是不可能的，因为它们彼此密切相关。更复杂的是，女性和男性在第一次中风时的功能基线状态大不相同，因此与男性相比，女性平均报告/确定的基线功能较差。这些基线变量的差异在很大程度上解释了女性和男性卒中后结果的差异。调整这些基线差异很困难，而且在许多情况下，不能排除残余混杂。尽管有这些障碍，更好地了解患者性别和性别差异如何影响急性中风和中风护理途径对于避免偏见并使我们能够为所有急性中风患者提供最好的护理至关重要。一方面忽视患者的性别和性别，另一方面忽视性别和性别分层分析中的潜在混杂因素，可能导致研究人员得出错误的结论，并可能导致医生提供次优护理。本综述概述了急性卒中关键方面的性和性别相关因素，包括急性卒中流行病学、诊断、获得护理、治疗结果和急性期后护理。我们还试图概述值得进一步详细研究的知识差距，以及对医生在日常实践中治疗急性中风患者的实际意义。