abstract: 'BACKGROUND: Strokes in the working-age population represent a relevant

  share of ischemic strokes and re-employment is a major factor for

  well-being in these patients. Income differences by sex have been

  suspected a barrier for women in returning to paid work following

  ischemic stroke. We aim to identify predictors of (not) returning to

  paid work in patients with large vessel occlusion treated with

  mechanical thrombectomy (MT) to identify potential areas of targeted

  vocational rehabilitation.

  METHODS: From 6635 patients enrolled in the German Stroke Registry

  Endovascular Treatment between 2015 and 2019, data of 606 patients of

  the working population who survived large vessel occlusion at least 90

  days past MT were compared based on employment status at day 90

  follow-up. Univariate analysis, multiple logistic regression and

  analyses of area under the curve were performed to identify predictors

  of re-employment.

  RESULTS: We report 35.6\% of patients being re-employed 3 months

  following MT (median age 54.0 years; 36.1\% of men, 34.5\% of women

  {[}P=0.722]). We identified independent negative predictors against

  re-employment being female sex (odds ratio {[}OR], 0.427 {[}95\% CI,

  0.229-0.794]; P=0.007), higher National Institutes of Health Stroke

  Scale (NIHSS) score 24 hours after MT (OR, 0.775 {[}95\% CI,

  0.705-0.852]; P<0.001), large vessel occlusion due to large-artery

  atherosclerosis (OR, 0.558 {[}95\% CI, 0.312-0.997]; P=0.049) and longer

  hospital stay (OR, 0.930 {[}95\% CI, 0.868-0.998]; P=0.043). Positive

  predictors favoring re-employment were excellent functional outcome

  (modified Rankin Scale score of 0-1) at 90 day follow-up (OR, 11.335

  {[}95\% CI, 4.864-26.415]; P<.001) and combined treatment with

  intravenous thrombolysis (OR, 1.904 {[}95\% CI, 1.046-3.466]; P=0.035).

  Multiple regression modeling increased predictive power of re-employment

  status significantly over prediction by best single functional outcome

  parameter (National Institutes of Health Stroke Scale 24 hours after MT

  <= 5; R-2: 0.582 versus 0.432; area under the receiver operating

  characteristic curve: 0.887 versus 0.835, P<0.001).

  CONCLUSIONS: There is more to re-employment after MT than functional

  outcome alone. In particular, attention should be paid to possible

  systemic barriers deterring women from resuming paid work.'
affiliation: 'Groschel, K (Corresponding Author), Johannes Gutenberg Univ Mainz, Univ
  Med Ctr, Dept Neurol, Langenbeckstr 1, D-55131 Mainz, Germany.

  Hahn, Marianne; Groeschel, Sonja; Hayani, Eyad; Muthuraman, Muthuraman; Groeschel,
  Klaus; Uphaus, Timo, Johannes Gutenberg Univ Mainz, Univ Med Ctr, Dept Neurol, Langenbeckstr
  1, D-55131 Mainz, Germany.

  Brockmann, Marc A., Johannes Gutenberg Univ Mainz, Univ Med Ctr, Dept Neuroradiol,
  Mainz, Germany.'
author: Hahn, Marianne and Groeschel, Sonja and Hayani, Eyad and Brockmann, Marc A.
  and Muthuraman, Muthuraman and Groeschel, Klaus and Uphaus, Timo and Tr, German
  Stroke Registry Endovasc
author-email: klaus.groeschel@unimedizin-mainz.de
author_list:
- family: Hahn
  given: Marianne
- family: Groeschel
  given: Sonja
- family: Hayani
  given: Eyad
- family: Brockmann
  given: Marc A.
- family: Muthuraman
  given: Muthuraman
- family: Groeschel
  given: Klaus
- family: Uphaus
  given: Timo
- family: Tr
  given: German Stroke Registry Endovasc
da: '2023-09-28'
doi: 10.1161/STROKEAHA.121.037386
eissn: 1524-4628
files: []
issn: 0039-2499
journal: STROKE
keywords-plus: ISCHEMIC-STROKE; RETURN; WORK; PREDICTORS; SURVIVORS; ADULTS; LIFE
language: English
month: AUG
number: '8'
number-of-cited-references: '27'
orcid-numbers: 'Poli, Sven/0000-0002-0286-8781

  Groschel, Klaus/0000-0002-0244-6116

  Dichgans, Martin/0000-0002-0654-387X

  Hahn, Marianne/0000-0002-9462-3844'
pages: 2528-2537
papis_id: 3a5fff2d658c586fe0a39434df520f3d
ref: Hahn2022sexdisparities
researcherid-numbers: 'Poli, Sven/HLH-8305-2023

  '
times-cited: '1'
title: Sex Disparities in Re-Employment in Stroke Patients With Large Vessel Occlusion
  Undergoing Mechanical Thrombectomy
type: Article
unique-id: WOS:000828987800026
usage-count-last-180-days: '0'
usage-count-since-2013: '3'
volume: '53'
web-of-science-categories: Clinical Neurology; Peripheral Vascular Disease
year: '2022'