Sex differences in the clinical and surgical management after intracerebral hemorrhage: A post hoc analysis of the INTERACT3 clinical trial.
Ma Ignacia Allende, Cheryl Carcel, Paula Muñoz-Venturelli et al.
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In 30 seconds
This post hoc analysis of the international, stepped-wedge cluster-randomised INTERACT3 trial examined sex differences in acute clinical and surgical care among 7,036 adults with intracerebral hemorrhage; 36% were female. Overall care and surgical intervention rates were similar between sexes, including in analyses of larger supratentorial hemorrhages. Compared with males, females had higher odds of receiving assisted feeding (OR 1.15, 95% CI = 1.02-1.31) and lower odds of withdrawal from active care (OR 0.41, 95% CI = 0.19-0.87).
Key findings
- Females were more likely than males to receive assisted feeding (OR 1.15, 95% CI = 1.02-1.31).
- Females were less likely than males to have active care withdrawn (OR 0.41, 95% CI = 0.19-0.87).
- Surgical intervention rates were similar by sex, including among patients with supratentorial ICH and hematoma volumes ⩾ 30 mL.
- Three care classes were identified—high-intensity, high-rehabilitation, and low-intensity—with comparable distributions for females and males.
Why it matters
The findings suggest that broadly similar acute ICH care across sexes is achievable in the settings studied, while differences in assisted feeding and withdrawal decisions identify areas for closer review. Assessing access alongside the timing and frequency of interventions may help clarify whether remaining differences reflect clinical need, decision-making, or care processes.
What to keep in mind
This was a post hoc analysis of trial participants, so findings may not represent all patients with ICH or establish why observed care differences occurred.